乙型肝炎和丁型肝炎病毒合并感染所致慢性肝炎的治疗。
Treatment of chronic hepatitis due to hepatitis B and hepatitis delta virus coinfection.
机构信息
Infectious Diseases, Department of Molecular Medicine, University of Padua, Padua, Italy.
Infectious Diseases, Department of Mental and Physical Health, Campania University, Naples, Italy.
出版信息
Int J Antimicrob Agents. 2019 Dec;54(6):697-701. doi: 10.1016/j.ijantimicag.2019.09.012. Epub 2019 Sep 18.
An estimated 20-40 million individuals worldwide are infected with hepatitis delta virus (HDV), mostly with rapidly evolving liver disease. Therapy of chronic HDV infection remains an unmet need. To date, only interferon (IFN)-based therapy is recommended for HDV infection and response rates are unsatisfactory; in addition, many patients are intolerant to or ineligible for IFN treatment. In recent years, innovative approaches have been in development, including the following: targeting virus entry into hepatocytes; inhibition of the host enzyme farnesyltransferase by prenylation inhibitors, leading to inhibition of complete virion formation and release; blockade of hepatitis B surface antigen (HBsAg) secretion, inhibiting virus release; and IFN-lambda, which causes fewer adverse effects than IFN-alfa. Clinical trials are ongoing with encouraging preliminary results.
据估计，全球有 2000 万至 4000 万人感染了乙型肝炎 delta 病毒（HDV），其中大多数人患有迅速进展的肝脏疾病。慢性 HDV 感染的治疗仍然是一个未满足的需求。迄今为止，仅推荐干扰素（IFN）治疗 HDV 感染，但反应率并不令人满意；此外，许多患者不耐受或不适合 IFN 治疗。近年来，已经开发出了一些创新方法，包括以下几种：靶向病毒进入肝细胞；通过prenylation 抑制剂抑制宿主酶法呢基转移酶，从而抑制完整病毒颗粒的形成和释放；阻断乙型肝炎表面抗原（HBsAg）的分泌，抑制病毒释放；以及 IFN-lambda，其引起的不良反应比 IFN-alfa 少。正在进行临床试验，初步结果令人鼓舞。
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