Best practices for screening, testing, diagnosing, and treating patients with hepatitis D (delta) virus based on global expert review and recent guidelines.

IF 2.3 4区 医学 Q4 INFECTIOUS DISEASES
Antiviral Therapy Pub Date : 2025-10-01 Epub Date: 2025-09-29 DOI:10.1177/13596535251349380
Markus Cornberg, Fabien Zoulim, Robert Gish, Ira M Jacobson, Tatyana Kushner, Pietro Lampertico, Mario Rizzetto, Cihan Yurdaydin, Michael Manns
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引用次数: 0

Abstract

BackgroundHepatitis D virus (HDV) represents the most severe form of human viral hepatitis, associated with rapid progression to cirrhosis and increased liver-related mortality. Globally, an estimated 9-19 million individuals are anti-HDV positive. To ensure early detetion, current guidelines recommend screening all HBsAg-positive individuals or, at a minimum, those with defined risk factors.MethodsThis expert consensus paper updates the current landscape of HDV management. Recommendations were derived from a structured expert panel discussion, incorporating recent evidence and clinical guideline developments, with a focus on screening, diagnosis, and antiviral therapy.ResultsThe panel emphasized the importance of systematic HDV screening in HBsAg-positive individuals. Therapeutic strategies aim at sustained HDV-RNA suppression and, ideally, HBV surface antigens (HBsAg) loss. Bulevirtide was recommended as a long-term monotherapy. Pegylated interferon alpha (PEG-IFNα), if used, should be limited to 48 weeks and tailored based on viral response and tolerability. Combination therapy with bulevirtide and PEG-IFNα may be considered in selected cases.ConclusionThis consensus provides updated recommendations for the screening, diagnosis, and treatment of HDV infection, highlighting the role of bulevirtide and individualized therapeutic approaches. As the treatment landscape continues to evolve, combination regimens and novel agents currently under investigation may offer additional options in the near future.

基于全球专家审查和最新指南的丁型肝炎(丁型)病毒患者筛查、检测、诊断和治疗最佳做法。
丁型肝炎病毒(HDV)是人类病毒性肝炎最严重的形式,与迅速发展为肝硬化和肝脏相关死亡率增加有关。在全球范围内,估计有900万至1900万人呈抗艾滋病毒阳性。为确保早期发现,目前的指南建议对所有hbsag阳性个体进行筛查,或至少对具有明确危险因素的个体进行筛查。方法本专家共识论文更新了HDV管理的现状。建议来自有组织的专家小组讨论,结合了最近的证据和临床指南的发展,重点是筛查、诊断和抗病毒治疗。结果专家组强调了在hbsag阳性个体中进行系统的HDV筛查的重要性。治疗策略旨在持续抑制HBV - rna,理想情况下,减少HBV表面抗原(HBsAg)。布利韦肽被推荐为长期单药治疗。如果使用聚乙二醇化干扰素α (PEG-IFNα),应限制在48周内,并根据病毒反应和耐受性进行调整。在选定的病例中,可以考虑布利韦肽和PEG-IFNα联合治疗。结论这一共识为HDV感染的筛查、诊断和治疗提供了最新的建议,强调了布来韦肽和个体化治疗方法的作用。随着治疗领域的不断发展,目前正在研究的联合方案和新药可能在不久的将来提供额外的选择。
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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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