Hepatitis D. The present state of the problem and unsolved problems


Syutkin V.E., Salienko A.A.

Moscow Liver Transplantation Center, N.V. Sklifosovsky Research Institute of Emergency Care, Moscow
The discovery of hepatitis D virus (HDV) dates back to the mid-1970s and is associated with the detection of a novel nuclear antigen in patients with severe forms of hepatitis B. HDV is present in all age groups and widespread, but not in all regions of the world at equal frequency. HDV genomes of different isolates present about 40% heterogeneity. There are at least 8 HDV genotypes with varying prevalence rates. HDV is the least among the animal RNA viruses, the replication of which depends on the enzyme systems of a host hepatocyte and the virion assembly is related to the protein structures of hepatitis B virus (HBV). HDV RNA encodes the only protein – HDAg. Minor protein is a major transcription product. Since HBV is essential for the assembly and intercellular spread of HDV, the infection caused by the latter is generally related to HBV infection. Hepatitis may have a severe course and show two peaks for the enhanced activity of transaminases. The main cause of death in patients with chronic hepatitis B + D is hepatic failure in the outcome of liver cirrhosis. Together with interferons, direct-acting antiviral agents are used to treat chronic hepatitides B and C. Standard interferon-α and pegylated interferon-α are the only class of medicines that may ensure 25-30% steady-state HDV viremia elimination.

About the Autors


Syutkin Vladimir Evgenyevich, MD; Leading Researcher, Moscow Liver Transplantation Center, N.V. Sklifosovsky Research Institute of Emergency Care
Address: 3, Bolshaya Sukharevskaya Sq., Moscow 129010
Telephone: +7(495) 680-41-54
E-mail: vsyutkin@kurkino.net.ru


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