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Semin Liver Dis 2018; 38(01): 066-072
DOI: 10.1055/s-0037-1621711
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Targeting Hepatitis D

Mario Rizzetto
1   Division of Gastroenterology, University of Torino, Torino, Italy
› Author Affiliations
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Publication History

Publication Date:
22 February 2018 (online)

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Abstract

New therapeutic strategies to treat chronic hepatitis D are directed to deprive the hepatitis D virus (HDV) of functions necessary to complete its life cycle that are provided by the hepatitis B virus (HBV) and by the host. Current options are (1) the block by the synthetic peptide Myrcludex B of HBV surface antigen (HBsAg) entry into cells through the inhibition of the sodium taurocholate cotransporting receptor; (2) the inhibition with lonafarnib of the farnesylation of the large HD antigen, required for virion assembly; (3) the presumed reduction by the nucleic acid polymer REP 2139 of the release of the HBsAg and subviral HBV particles necessary for HD virion morphogenesis. Lonafarnib and Myrcludex in monotherapy reduced serum HDV-RNA but did not reduce the HBsAg and HD viremia rebounded after therapy; they may provide additional efficacy to pegylated interferon alpha (Peg IFN-α) therapy. Treatment with REP-2139 in combination with Peg IFN-α induced a sustained clearance both of the HDV-RNA and HBsAg in 5 of 12 patients, providing the best interim results so far obtained in the therapy of chronic hepatitis D.

Keywords

hepatitis D virus - chronic hepatitis D - Lonafarnib - Myrcludex B - REP 2139 - HDV therapy
 

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