[New therapeutic strategies against B and D hepatitis]

Abstract

Current treatments against the hepatitis B virus (HBV) efficiently inhibit viral replication but rarely lead to functional cure, defined as the loss of HBsAg. Persisting transcription from intranuclear forms of viral DNA, independently from viral replication, limits the possibility of a robust clearing response of the host against the virus. The new therapeutic approaches target either the transcription, with specific oligonucleotides, the capsid assembly or the release of complete viral particles from infected hepatocytes. Some clinical trials seem highly promising. Although the clinical evolution of hepatitis Delta infection is more severe than the one caused by HBV, our tools to fight the virus are even less developed. In addition to the strategies used for HBV, molecules targeting HDV entry or HDAg prenylation are currently being evaluated. We review the main characteristics of HBV and HDV viral replication and highlight the results obtained in clinical trials using the most advanced molecules developed to overcome these infections.

Keywords: chronic infection; cure; immunomodulation; persistence; viral hepatitis; virological markers.