处于停滞状态的慢性丁型肝炎：我们在哪里何去何从？

StephenW

Chronic hepatitis D at a standstill: where do we go from here?

    Alessia Ciancio   
    & Mario Rizzetto   

    Nature Reviews Gastroenterology & Hepatology
    11,
    68–71
    (2014)
    doi:10.1038/nrgastro.2013.164

Published online
    10 September 2013


Abstract

   

Immigration is fuelling a new reservoir of hepatitis D virus (HDV) in Europe, and hepatitis D still represents an important medical problem in the USA. The disease continues to be a major medical scourge in the developing world, in particular in countries such as Pakistan, Mongolia and Mauritania. New therapeutic strategies are being developed to disrupt interactions between HDV and its viral partner HBV, or with the host. Blocking or modifying the hepatitis B surface antigen (HBsAg) might interfere with the uptake or release of the hepatitis D virion; interference with host-mediated post-translational changes of proteins that are crucial to the HDV life cycle, such as prenylation, is another potential therapeutic option. At present, however, the only realistic option is to optimize IFN-α therapy. As eradication of HBsAg is the ultimate end point of therapy, long-term interferon administration might be required, raising an issue of tolerance in patients. Treatment with IFN-λ is a potential alternative approach to IFN-α; treatment of hepatitis C with this cytokine seems to cause fewer adverse effects than IFN-α and, therefore, might be more suitable for long-term treatment of HDV.

移民局是助长丁型肝炎病毒（HDV ）在欧洲的新水库，和丁型肝炎仍然代表着美国的一个重要的医学问题。这种疾病仍然是一个主要的医疗祸害在发展中世界，特别是在国家，如巴基斯坦，蒙古和毛里塔尼亚。正在开发新的治疗策略，扰乱HDV和其合作伙伴病毒乙肝病毒之间的相互作用，或与主机。阻断或修改乙型肝炎表面抗原（HBsAg）可能与摄取或丁型肝炎病毒颗粒的释放造成干扰;与宿主介导的翻译后的蛋白质，是至关重要的HDV的生活周期，如异戊烯化的变化的干扰，是另一潜在的治疗选项。但目前，唯一现实的选择是优化IFN-α治疗。作为消除的HBsAg是治疗的最终终点，长期施用干扰素可能需要，提高耐受患者的问题。治疗用IFN- λ是一个潜在的替代方法，以IFN- α ;治疗C型肝炎与该细胞因子似乎导致比IFN- α的不良反应，因此，可能更适合于长期治疗的HDV 。