Abstract:
Hepatitis B virus is a small enveloped RNA virus, which replicates independently but requires the hepatitis B virus (HBV) to provide the envelope proteins necessary for the assembly of its own viral particles. Approximately 5% of chronic hepatitis B virus carriers are infected with HDV. HBV vaccination remains the best preventive treatment for HDV. All HBV patients should be screened for HDV (anti-HDV serology). In case of positive HDV serology, HDV replication (HDV RNA) should be investigated using a sensitive and specific technique. Hepatitis Delta is often complicated by cirrhosis and hepatocellular carcinoma (HCC). For this reason, every patient with Delta cirrhosis should be screened for HCC by abdominal ultrasound every 6 months. The historical treatment was based on PEG-IFN with many side effects. A new treatment has been approved, Bulevirtide (Hepcludex®) an HDV/HBV entry inhibitor, for any patient with chronic hepatitis Delta infection (CHD) with active replication (except in decompensated cirrhosis), at a dose of 2mg/day by subcutaneous injection. The exact duration on-treatment is unknown, thus treatment should be continued if clinical benefit is observed.
摘要:
乙型肝炎病毒是一种小的包膜RNA病毒,独立复制,但需要乙型肝炎病毒(HBV)提供其自身病毒颗粒组装所需的包膜蛋白。约5%的慢性乙型肝炎病毒携带者感染HDV。乙肝疫苗接种仍然是HDV的最佳预防治疗方法。所有HBV患者应筛查HDV(抗HDV血清学)。在HDV血清学阳性的情况下,HDV复制(HDVRNA)应使用敏感和特定的技术进行研究。丁型肝炎通常并发肝硬化和肝细胞癌(HCC)。出于这个原因,每位Delta肝硬化患者应每6个月通过腹部超声筛查HCC.历史治疗基于PEG-IFN,具有许多副作用。一种新的治疗方法被批准,Bulevirtide(Hepcludex®)一种HDV/HBV进入抑制剂,对于任何患有慢性丁型肝炎感染(CHD)并伴有活动性复制(失代偿期肝硬化除外)的患者,以2mg/天的剂量通过皮下注射。治疗的确切持续时间未知,因此,如果观察到临床获益,应继续治疗。