Hepatitis D – Cure
Developing a better understanding and new therapies for a previously neglected virus. With Bulevirtide/Hepcludex®, there is a first drug against hepatitis D.
Of the approximately 250 million people worldwide chronically infected with hepatitis B, about 15 to 25 million are also infected with the hepatitis D virus (HDV). HDV uses the hepatitis B virus (HBV) as a helper virus by packaging its genome with the HBV envelope. HBV/HDV co-infection leads to the most severe course of viral liver disease.
Unfortunately, the antiviral drugs approved to treat people with hepatitis B are not effective against HDV infection. Interferon alpha only shows limited efficacy in some patients but has severe side effects and does not lead to a cure in most cases. There was thus a great need for action with regard to the development of HDV-specific therapies and strategies that enable a cure of the infection.
The video series "Hepatitis D: B aware" provides knowledge to understand the risk of hepatitis D infection associated with the hepatitis B virus. You can find the full playlist of videos here. The DZIF research area Hepatitis created this series in collaboration with renowned organizations, specialist institutions and research consortia (active content from YouTube is only loaded and personal data is only transferred to YouTube when this video is called up; more information in our privacy policy).
With the development of Bulevirtid/Hepcludex® as the first approved drug for hepatitis D, the goal of a well-tolerated and effective treatment option has become a reality, even though the therapy involves continuous medication. As many aspects of the virus are still poorly understood, there is a need to identify potential therapeutic synergies that could lead to faster and more targeted cures.
In addition, the estimated number of infected people is likely to be underestimated due to a lack of knowledge about the spread of HDV. Finally, there is a lack of understanding of the mechanisms of the body's immune system that could potentially eliminate the virus after therapeutic intervention. Knowledge of risk factors, disease progression, response to therapy and the immune response is therefore important for improving therapeutic options and personalizing treatment.
Destroying the basis of replication
HDV is the smallest human viral pathogen. HDV uses the HBV envelope to pack its genome in order to exit the liver cell and spread. In addition, the genetic information of the virus can also spread in the liver through cell division of infected hepatocytes.
The new entry inhibitor bulevirtide, which was developed in part within the DZIF, effectively inhibits HDV entry into liver cells, thereby protecting newly formed liver cells from infection. However, to inhibit the spread of HDV from cell to cell and thus potentially achieve a cure by elimination, further efforts are needed, which are being undertaken as part of our investigations.
These include both the identification of synergistic antivirals and a better understanding of the immunological processes involved in HDV cure. DZIF scientists have recently developed a diagnostic test that allows rapid detection of HDV infection. This will facilitate the screening of patients and help improve future treatment options.
