Delta hepatitis, a rare and aggressive disease that now has an effective therapy – breaking latest news

a lame virus, which alone would not be able to replicate itself: to do so it needs to have another virus as a companion, that of’epatite B (Hbv). Not for this Hdvthe virus ofDelta hepatitisshould be underestimated: responsible for a very aggressive hepatitis, which progresses up to 10 times faster than the hepatitis B it always goes with. That is why the publication on the New England Journal of Medicine of an international research that confirms the effectiveness of boulevardsthe first drug approved by the European Medicines Agency and recently also by the Italian Medicines Agency for the treatment of Delta hepatitis: the new data show that two years after the start of the therapy, which consists of injecting the subcutaneous drug at a dose of 2 milligrams once a day, the viral load is drastically reduced and also the transaminases, the liver enzymes indicative of liver function, return to normal.

Excellent results for patients who did not have many opportunities for treatment in the face of a disease that can quickly lead to the need for a transplant: Delta hepatitis is the most aggressive and so far it was also thereIt’s unique without a therapy: bulevirtide is the first drug whose efficacy in monotherapy has been demonstrated, without the use of interferon, explains Pietro Lampertico, director of the Gastroenterology and Hepatology Unit of the Milan Polyclinic and co-author of the survey.

Rare disease

Delta hepatitis considered one rare disease: it is estimated to be present in about 5 percent of hepatitis B carriers, therefore in the world there are assumed 12-15 million patients with Delta hepatitis, in Italy from 5 to 10 thousand people. In the last 30 years, patients have been treated with interferon due to co-infection with Hbv, but the therapy works in about 15-20 percent of cases, causes side effects and often cannot be used due to patient characteristics, for example in the elderly or seriously ill. Bulevirtide, in the face of manageable side effects, in 45 percent of patients leads to a drastic reduction in the viral load (which in 12 percent of patients is no longer detectable) and to the restoration of liver enzymes: The drug blocks the protein on the liver cells that allows the virus to enter, thus the viral replication stops and the inflammation decreases. Thus the virus and liver damage are curbed, with positive effects even in patients with advanced cirrhosis.

Three types of cases

The therapy works regardless of the severity of the disease and also from the patient’s age, explains Lampertico. Today there are in fact three main types of cases: Italians over 43 who contracted the hepatitis B virus before the vaccine became mandatory in 1991, immigrants from Eastern Europe or other countries who have lived in Italy for some time but are not vaccinated and often between the ages of 30 and 40, the new migrants arriving from countries where hepatitis B and Delta are common are even younger. The treatment was effective in all groups: it does not cure the disease because it does not eradicate the virus, as happens with the treatment for hepatitis C, but it suppresses it and helps avoid liver transplantation, which in addition to having costs that are even higher than those of the drug, cannot always be faced by patients, as well as compromising their quality of life. Also for this reason, although it is an expensive treatment, Aifa has provided for a broad indication of use, allowing its use in all patients with compensated delta hepatitis, concludes Lampertico.