Persistent coinfection with the hepatitis B/D viruses (HDV) represents the most severe form of viral hepatitis. Hepatitis D often leads to liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma. The current treatment options are limited as only pegylated interferon-alpha (PEG-IFNa) has efficacy against HDV. However, treatment response is still unsatisfactory with 25-40% HDV RNA suppression after 1-2 years. In addition, late HDV RNA relapses have been described during long-term follow-up. Fortunately, new treatment options for patients with chronic hepatitis delta are now on the horizon. The hepatocyte entry inhibitor bulevirtide (formerly myrcludex B) and the farnesyl transferase inhibitor lonafarnib are currently explored in patients with chronic hepatitis delta in Phase 3 clinical studies. The nucleic acid inhibitor REP-2139-Ca and PEG-IFN-lambda are studied in Phase 2 trials. We here summarize data on the efficacy of these new antiviral drugs and the existing safety data on the treatment of HDV infection.

中文翻译：

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超越聚乙二醇化干扰素-α：肝炎三角洲的新疗法。

持续感染B / D肝炎病毒（HDV）是最严重的病毒性肝炎形式。丁型肝炎通常会导致肝硬化，肝代偿失调和肝细胞癌。当前的治疗选择受到限制，因为只有聚乙二醇化的干扰素-α（PEG-IFNa）具有对抗HDV的功效。但是，1-2年后25％至40％的HDV RNA抑制仍不能令人满意的治疗反应。此外，在长期随访中已描述了晚期HDV RNA复发。幸运的是，针对慢性乙型肝炎三角洲患者的新治疗方案现已浮出水面。肝细胞进入抑制剂bulevirtide（以前为myrcludex B）和法尼基转移酶抑制剂lonafarnib目前正在3期临床研究中用于患有慢性肝炎三角洲的患者中。在2期试验中研究了核酸抑制剂REP-2139-Ca和PEG-IFN-λ。我们在这里总结有关这些新抗病毒药物功效的数据以及有关HDV感染治疗的现有安全性数据。