Wortmann N, Höner Zu Siederdissen C, Cornberg M
Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Deutsches Zentrum für Infektionsforschung (DZIF), Standort Hannover-Braunschweig, Hannover, Deutschland.
Internist (Berl). 2018 Jun;59(6):519-527. doi: 10.1007/s00108-018-0432-3.
Worldwide, hepatitis B virus (HBV) infection is among the 30 leading causes of death, despite effective vaccination and therapeutic options. Chronic hepatitis delta (coinfection with hepatitis D virus) leads to a rapid disease progression.
Based on current international guidelines and studies, an overview about present and future therapeutic options for chronic hepatitis B and delta is provided.
Therapy with nucleoside or nucleotide analogues leads to nearly complete HBV DNA suppression, which is associated with regression of liver fibrosis and a lower risk for the development of hepatocellular carcinoma. Therapy of chronic hepatitis delta with pegylated interferon alfa achieves only low response rates with high risk for virological relapse. Various therapeutic approaches are currently being investigated in preclinical and clinical studies and have led to a significant reduction of hepatitis B surface antigen (HBsAg) and HDV RNA.
Current therapies of chronic HBV infection can effectively reduce subsequent complications. New therapeutic approaches promise functional cure (HBsAg loss) of HBV infection and effective treatment options for patients with chronic hepatitis delta.
在全球范围内，尽管有有效的疫苗接种和治疗选择，但乙型肝炎病毒（HBV）感染仍是30大主要死因之一。慢性丁型肝炎（丁型肝炎病毒合并感染）会导致疾病快速进展。
基于当前国际指南和研究，对慢性乙型肝炎和丁型肝炎的现有及未来治疗选择进行概述。
核苷或核苷酸类似物治疗可使HBV DNA几乎完全被抑制，这与肝纤维化的消退以及肝细胞癌发生风险降低相关。聚乙二醇化干扰素α治疗慢性丁型肝炎的应答率很低，且病毒学复发风险高。目前正在临床前和临床研究中探索各种治疗方法，这些方法已使乙型肝炎表面抗原（HBsAg）和丁型肝炎病毒RNA显著减少。
目前慢性HBV感染的治疗可有效降低后续并发症。新的治疗方法有望实现HBV感染的功能性治愈（HBsAg消失），并为慢性丁型肝炎患者提供有效的治疗选择。
