Barts Liver Centre, Blizard Institute, Barts and The London, School of Medicine & Dentistry, Queen Mary University of London, London, UK.
J Viral Hepat. 2023 Apr;30 Suppl 1:21-25. doi: 10.1111/jvh.13785. Epub 2023 Jan 11.
Hepatitis delta virus (HDV) is known to cause the most aggressive and severe form of viral hepatitis, yet it remained under-diagnosed but does require early diagnosis for accurate disease staging. Antibody to HDV (anti-HDV) is the primary screening tool and should be assessed in patients with hepatitis B surface antigen (HBsAg) positivity, as HDV is a satellite RNA virus of hepatitis B. Additionally, the viral load (HDV RNA) should be assessed in those with positive anti-HDV, to differentiate between active infection and resolved hepatitis delta. Data regarding immune responses in HDV are limited but show dysfunctional adaptive and innate immunity. Many studies however fail to distinguish between active and resolved infection. Limited treatments are available for HDV, but promise has been shown with the newly approved Bulevirtide, a first-in-class HBV entry inhibitor. Thus immune response during therapy requires further investigation, along with additional targets for HDV cure.
乙型肝炎病毒 delta 型（HDV）是已知引起最具侵袭性和最严重形式的病毒性肝炎的病毒，但它仍然诊断不足，但确实需要早期诊断以进行准确的疾病分期。抗 HDV（抗-HDV）是主要的筛选工具，应在乙型肝炎表面抗原（HBsAg）阳性的患者中进行评估，因为 HDV 是乙型肝炎的卫星 RNA 病毒。此外，对于抗-HDV 阳性的患者，应评估病毒载量（HDV RNA），以区分活动性感染和已解决的 delta 肝炎。关于 HDV 免疫反应的数据有限，但显示适应性和先天免疫功能障碍。然而，许多研究未能区分活动性和已解决的感染。HDV 的治疗方法有限，但新批准的 Bulevirtide（一种新型乙型肝炎病毒进入抑制剂）显示出了希望。因此，治疗期间的免疫反应需要进一步研究，同时也需要针对 HDV 治愈的其他靶点。
