Towards curative therapy of chronic viral hepatitis

Abstract

Persistent infection with hepatitis viruses is a major medical burden that unfortunately is often ignored in the general public. This results in a massive under-diagnosis of these infections. According to the world health organization, the number of people dying every year from the consequence of hepatitis virus infection has surpassed the death rate caused by malaria and HIV and is equivalent to the one of tuberculosis. These numbers call for more intense efforts to devise more effective, ideally curative therapies that must become as widely accessible as they are e. g. for HIV infected individuals. A major step forward has been the development of curative antiviral therapy for chronic hepatitis C. In the case of hepatitis D virus, new drug candidates have been developed that should receive conditional approval very soon. For chronic hepatitis B, development is lagging behind but thanks to a re-emerging interest of pharmaceutical industry that was triggered by the success of hepatitis C therapy and the availability of novel infection systems, new attempts towards curative approaches for this highly prevalent infection are undertaken. Here we summarize the current status of therapy development for chronic viral hepatitis that ultimately aims at cure.

Zusammenfassung

Persistente Infektionen mit Hepatitis-Viren sind ein wichtiges medizinisches Problem, das in der Öffentlichkeit häufig wenig Beachtung findet. Daraus resultiert eine massive Unterdiagnose dieser Infektionen. Nach jüngsten Schätzungen der Weltgesundheitsorganisation ist die Zahl der Todesfälle aufgrund einer Virushepatitis mittlerweile höher als die durch Malaria und HIV-Infektionen und vergleichbar mit der durch Tuberkulose. Diese Zahlen belegen eindrücklich, dass mehr Anstrengungen unternommen werden müssen, um bessere Therapien, die idealerweise kurativ sind, zu entwickeln und auf breiter Basis verfügbar zu machen, so wie es beispielsweise bei der Therapie der HIV-Infektion erreicht wurde. Ein wichtiger Schritt in diese Richtung war die Entwicklung von kurativen Therapien der Hepatitis-C-Virus-Infektion. Im Fall des Hepatitis-D-Virus wurden neue Wirkstoffe entwickelt, mit deren Zulassung wir schon sehr bald rechnen können. Bei der chronischen Hepatitis B hinkt die Entwicklung hinterher, aber motiviert durch die Therapieerfolge in der chronischen Hepatitis C und der Verfügbarkeit neuer Infektionssysteme wurde das Interesse der pharmazeutischen Industrie an einer kurativen Therapie der Hepatitis B geweckt. Zahlreiche Wirkstoffkandidaten befinden sich zurzeit in präklinischer und klinischer Entwicklung und man darf hoffen, dass diese die Klinik erreichen und zumindest bei einem Teil der Patienten kurativ wirken. In dieser Übersicht fassen wir den aktuellen Stand der Therapieentwicklungen für die chronische Virushepatitis mit dem Fernziel der Heilung zusammen.

Key words

viral hepatitis - hepatitis virus - hepatitis B - hepatitis D - hepatitis C - curative therapy

Schlüsselwörter

Virushepatitis - Hepatitis Virus - Hepatitis B - Hepatitis D - Hepatitis C - Kurative Therapie

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