Hepatitis D infection:from initial discovery to current investigational therapies

丁型肝炎:从最初的发现到如今的治疗研究

Hepatitis D is the most severe form of viral hepatitis associated with a more rapid progression to cirrhosis and an increased risk of hepatocellular carcinoma and mortality compared with hepatitis B mono-infection.Although once thought of as a disappearing disease,hepatitis D is now becoming recognized as a serious worldwide issue due to improvement in diagnostic testing and immigration from endemic countries.Despite these concerns,there is currently only one accepted medical therapy(pegylated-interferon-a)for the treatment of hepatitis D with less than desirable efficacy and significant side effects.Due to these reasons,many patients never undergo treatment.However,increasing knowledge about the virus and its life cycle has led to the clinical development of multiple promising new therapies that hope to alter the natural history of this disease and improve patient outcome.In this article,we will review the literature from discovery to the current investigational therapies.

丁型肝炎是最严重的病毒性肝炎。与单纯乙型肝炎相比,丁型肝炎向肝硬化进展更快,患肝细胞癌的风险增加,死亡率也更高。尽管丁型肝炎曾经一度被认为已经消失,但随着诊断方法的进步和高发国家移民的增多,该病已成为一个严重的世界性的健康问题。尽管深受关切,但丁型肝炎目前只有唯一一种被接受的治疗药物(聚乙二醇干扰素α),而且该药物疗效并不甚满意,且不良反应明显。因而,许多患者都不去接受治疗。然而,随着对该病毒及其生长周期的认识不断深入,临床上涌现出多种有希望的新药,有望改变丁型肝炎的自然生长,提高治疗效果。本文对丁型肝炎从发现到如今的治疗研究进行文献综述。