jofinЖурнал инфектологииJournal Infectology2072-6732IPO “АIDSSPbR"10.22625/2072-6732-2024-16-3-24-35jofin-1659Research ArticleОбзорыReviewСовременные аспекты противовирусной терапии гепатита DModern aspects of anti-viral therapy for hepatitis DЖелезноваА. С.ZheleznovaA. S.

Железнова Алина Сергеевна – младший научный сотрудник отдела молекулярной вирусологии флавивирусов и вирусных гепатитов

тел.: +7-953-878-14-66 

Новосибирск 

 Novosibirsk 

zheleznova_as@vector.nsc.ruСвиринК. А.SvirinK. A.

Свирин Кирилл Андреевич – младший научный сотрудник отдела молекулярной вирусологии флавивирусов и вирусных гепатитов

тел.: +7-913-107-60-67 

Новосибирск 

 Novosibirsk 

svirin_ka@vector.nsc.ruКарташовМ. Ю.KartashovM. Yu.

Карташов Михаил Юрьевич – старший научный сотрудник отдела молекулярной вирусологии флавивирусов и вирусных гепатитов, к.б.н.

тел.: +7-923-419-31-92

Новосибирск 

 Novosibirsk 

kartashov_myu@vector.nsc.ruГосударственный научный центр вирусологии и биотехнологии «Вектор»РоссияState Research Center of Virology and Biotechnology «Vector»Russian Federation2024210920241632435Copyright © Железнова А.С., Свирин К.А., Карташов М.Ю., 20242024Железнова А.С., Свирин К.А., Карташов М.Ю.Zheleznova A.S., Svirin K.A., Kartashov M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.niidi.ru/jofin/article/view/1659

Вирусный гепатит D (ВГD-инфекция) в 80–90% случаев ухудшает прогноз течения вирусного гепатита В, ускоряя фиброз и приводя к циррозу печени или гепатоцеллюлярной карциноме. Гепатитом D страдают не менее 125 тысяч россиян, а в мире, по приблизительным оценкам, насчитывается 15–20 млн больных. К основным мерам борьбы с гепатитом D можно отнести повсеместную плановую вакцинацию против гепатита В и назначение эффективной этиотропной терапии. Детальное изучение строения генома вируса гепатита D и цикла его репликации позволяет разрабатывать целый ряд препаратов, таргетно блокирующих ключевые механизмы жизненного цикла вируса. В обзоре дается краткая характеристика вируса гепатита D, строение его генома, ключевых процессов его жизненного цикла и механизмов реализации генетической информации. В обзоре рассмотрены основные потенциальные мишени для таргетной противовирусной терапии ВГDинфекции и описаны конкретные препараты (булевиртид, лонафарниб, полимеры нуклеиновых кислот). Отдельно рассматривается механизм действия булевиртида, являющегося, согласно современным отечественным клиническим рекомендациям, ключевым элементом противовирусной терапии в качестве монотерапии или в сочетании с пегилированными интерферонами. Также рассматриваются перспективные препараты, воздействующие на процессы синтеза и посттрансляционной модификации HDAg или снижающие продукцию поверхностных белков вируса гепатита В. С целью разработки безопасных, эффективных и экономически доступных лекарственных средств против гепатита D требуются дополнительные усилия, которые бы позволили обеспечить широкий доступ к лечению для тех, кто в нем отчаянно нуждается. Этим обусловливается важность дальнейшего более подробного изучения жизненного цикла вируса гепатита D с целью создания высокоэффективных противовирусных препаратов.

Viral hepatitis D (HDV infection) worsens the prognosis of HBV infection course in 80-90% of cases, accelerating fibrosis and leading to liver cirrhosis or hepatocellular carcinoma. Hepatitis D affects at least 125 000 people in Russia, and in the world, according to rough estimates, there are 15–20 million patients. The main measures to combat hepatitis D can be attributed to widespread scheduled vaccination against hepatitis B and the appointment of effective etiotropic therapy. A detailed study of the hepatitis D virus genome structure and its replication cycle allows the development of a number of drugs that target and block key mechanisms of the virus life cycle. This review provides a brief characterization of hepatitis D virus, its genome structure, key processes of its life cycle and mechanisms of genetic information realization. The review considers the main potential targets for targeted antiviral therapy of HDV infection and describes specific drugs (bulevirtide, lonafarnib, nucleic acid polymers). The review describes the mechanism of action of bulevirtide, which according to the current national clinical guidelines is a key element of antiviral therapy as monotherapy or in combination with pegylated interferons. Promising drugs affecting the processes of synthesis and post-translational modification of HDAg or reducing the production of surface proteins of hepatitis B virus are also considered. Further efforts are needed to develop safe, effective and cost-effective drugs against hepatitis D to ensure that treatment is widely available to those who desperately need it. Therefore, it is important that the life cycle of the hepatitis D virus be studied further, in greater detail, in order to develop highly effective antiviral drugs.

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The authors declare that there are no conflicts of interest present.