丁型肝炎诊疗现状及药物研发进展

Current status of diagnosis and treatment and progress in drug research and development for hepatitis D

慢性丁型肝炎是一种严重的病毒性肝炎,由丁型肝炎病毒(HDV)与乙型肝炎病毒(HBV)共感染或在HBV感染的基础上感染HDV所致。合并丁型肝炎的HBV感染者往往疾病进展更快、预后更差。然而一直以来公众和临床对慢性丁型肝炎关注度较低,加之检测手段的局限和筛查体系的缺失,世界各地区HDV筛查率均处于较低水平。既往治疗手段有效性不佳更是进一步降低了筛查诊疗的积极性。近年来抗HDV药物研发取得了进展,已有多种药物进入临床试验阶段,部分药物已在国际部分地区获批上市。在这一背景下,全球亦在积极探索提升HDV筛查率的有效手段。其中,英国、法国和西班牙等研究均显示触发试验模式可有效提高HDV筛查率,也为其他国家地区开展HDV筛查提供了参考。文章将对慢性丁型肝炎的检测手段、筛查和诊疗现状及药物研发进展进行综述,以期为临床医师了解HDV的诊断和治疗现状提供帮助。

Chronic hepatitis D is a kind of severe viral hepatitis caused by co-infection with hepatitis D virus(HDV)and hepatitis B virus(HBV)or infection with HDV on the ground of HBV infection.Patients with hepatitis D who are infected with HBV often have faster disease progression and a worse prognosis.However,the public and clinicians have always paid little attention to chronic hepatitis D.Coupled with the limitations of detection methods and the absence of a screening system,the HDV screening rate in various regions of the world is at a low level.Consequently,the enthusiasm for screening,diagnosis,and treatment has been further reduced by the inadequate effectiveness of previous treatment methods.In recent years,progress has been made in the research and development of anti-HDV drugs,and a variety of drugs have already entered the clinical trial stage,and some have already been approved for commercialization in specific parts of the world.In this context,the world is also actively exploring effective ways to increase the HDV screening rate.The reflex test model can effectively raise the HDV screening rate and serve as a reference for HDV screening in other countries and regions,as demonstrated by studies conducted in the United Kingdom,France,and Spain,among others.This article will review the detection methods,screening,diagnosis,and treatment current status,as well as the progress in drug research and development,in order to help clinical physicians understand chronic HDV diagnosis and treatment.