Khanam Arshi, Ameer Abutaleb, Mathur Poonam, Yurdaydin Cihan, Kottilil Shyam
Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
Pathogens. 2025 Aug 21;14(8):828. doi: 10.3390/pathogens14080828.
Chronic hepatitis delta (CHD) represents the most severe form of viral hepatitis due to rapid disease progression towards liver cancer, leading to high morbidity and mortality. Hepatitis delta virus (HDV) can only infect individuals who are infected with hepatitis B. So far, there is no cure or vaccine for HDV. Existing treatment options, including pegylated interferon-α and hepatocyte entry inhibitors, offer limited efficacy. Emerging therapeutic strategies are focused on targeting various steps of the HDV life cycle or enhancing the host immune response to promote viral elimination. A defective antiviral immune response is increasingly recognized as a culprit for HDV persistence; however, the precise immunological mechanism associated with disease progression and pathogenesis has not been well defined. This review provides an update on the current understanding of host immune response in CHD, highlighting its role in both disease pathogenesis and viral clearance. A deeper understanding of these immune correlates may lead the way to novel treatment strategies, including immunotherapies targeting host immune response that can be used in combination with other antiviral therapies to achieve more effective and durable treatment outcomes.
慢性丁型肝炎（CHD）是最严重的病毒性肝炎形式，因为疾病会迅速发展为肝癌，导致高发病率和高死亡率。丁型肝炎病毒（HDV）只能感染已感染乙型肝炎的个体。到目前为止，尚无针对HDV的治愈方法或疫苗。现有的治疗选择，包括聚乙二醇化干扰素-α和肝细胞进入抑制剂，疗效有限。新兴的治疗策略集中于靶向HDV生命周期的各个步骤或增强宿主免疫反应以促进病毒清除。抗病毒免疫反应缺陷越来越被认为是HDV持续存在的罪魁祸首；然而，与疾病进展和发病机制相关的精确免疫机制尚未明确界定。本综述提供了关于目前对CHD中宿主免疫反应理解的最新情况，强调了其在疾病发病机制和病毒清除中的作用。对这些免疫关联的更深入理解可能会为新的治疗策略指明方向，包括针对宿主免疫反应的免疫疗法，可与其他抗病毒疗法联合使用以实现更有效和持久的治疗效果。
