PDF(Pubmed)
Abstract：
Approximately 12-72 million people worldwide are co-infected with hepatitis B virus (HBV) and hepatitis delta virus (HDV). This concurrent infection can lead to several severe outcomes with hepatic disease, such as cirrhosis, fulminant hepatitis, and hepatocellular carcinoma, being the most common. Over the past few decades, a correlation between viral hepatitis and autoimmune diseases has been reported. Furthermore, autoantibodies have been detected in the serum of patients co-infected with HBV/HDV, and autoimmune features have been reported. However, to date, very few cases of clinically significant autoimmune hepatitis (AIH) have been reported in patients with HDV infection, mainly in those who have received treatment with pegylated interferon. Interestingly, there are some patients with HBV infection and AIH in whom HDV infection is unearthed after receiving treatment with immunosuppressants. Consequently, several questions remain unanswered with the challenge to distinguish whether it is autoimmune or \"autoimmune-like\" hepatitis being the most crucial. Second, it remains uncertain whether autoimmunity is induced by HBV or delta virus. Finally, we investigated whether the cause of AIH lies in the previous treatment of HDV with pegylated interferon. These pressing issues should be elucidated to clarify whether new antiviral treatments for HDV, such as Bulevirtide or immu-nosuppressive drugs, are more appropriate for the management of patients with HDV and AIH.
摘要：
全球约有12-72万人同时感染了乙型肝炎病毒（HBV）和丁型肝炎病毒（HDV）。这种并发感染可能导致肝脏疾病的几种严重结果，比如肝硬化，暴发性肝炎,和肝细胞癌，是最常见的。在过去的几十年里，已经报道了病毒性肝炎和自身免疫性疾病之间的相关性。此外，在合并感染HBV/HDV的患者的血清中检测到自身抗体，和自身免疫特征已被报道。然而,到目前为止,很少有临床上有意义的自身免疫性肝炎（AIH）在HDV感染患者中报道，主要是接受聚乙二醇干扰素治疗的患者。有趣的是,有一些HBV感染和AIH患者在接受免疫抑制剂治疗后发现HDV感染。因此,几个问题仍然没有答案，区分它是自身免疫性肝炎还是“自身免疫样肝炎”是最关键的挑战。第二,尚不确定自身免疫是否由HBV或delta病毒诱导。最后,我们调查了AIH的原因是否在于先前使用聚乙二醇干扰素治疗HDV。这些紧迫的问题应该阐明，以澄清是否新的抗病毒治疗HDV，如布列维肽或免疫抑制剂，更适合HDV和AIH患者的管理。
