What is Delta Hepatitis? Many are unaware of this infection, the most aggressive and dangerous form of chronic viral hepatitis because it progresses rapidly, causes cirrhosis, necrosis, tumors and can lead to death. The infectious agent is known as HDVa satellite virus that requires the presence of another virus for replication, that of hepatitis B. In Italy there are about fifteen thousand people affected by this disease.
Hepatitis B, drugs that boost the immune system against the virus are being studied
by Anna Lisa Bonfranceschi
The good news is the arrival of a new therapeutic approach that has the ability to block the replication of the infection, thus allowing patients to survive. The drug bulevirtide, presented in Rome during the 54th AISF National Congress – Italian Association for the Study of the Liver, on 24-25 March, has already been approved at European level and is awaiting the opinion of AIFA (Italian Medicines Agency ).
Delta hepatitis
“It is a viral infection caused by a very small virus, one of the smallest in the world, discovered in Turin by Professor Mario Rizzetto in 1977 – explains Professor Alessio AghemoAISF secretary – which causes inflammation and damage to the liver until it becomes cirrhotic and develops a tumor “.
With the hepatitis B vaccine, which arrived in the 1980s and became mandatory in 1991, there was a drastic reduction in cases, “but there is the phenomenon of migration from countries with a high rate of hepatitis and no vaccination, such as Asia, Eastern Europe, some areas of Africa, which puts our system in crisis “. Not to mention the lack of training: less than one in two patients with HBV is tested for the Delta.
How HDV is contracted and the damage it causes
“The infection is contracted like hepatitis B, which is mainly transmitted by parental, during childbirth, through sexual intercourse, infected biological materials, with the use of intravenous substances”, explains Aghemo. The HDV virus can only infect people with hepatitis B; the infection can be contextual, ie the person contracts both viruses together, or it can occur at a later time. “Inflammation of the liver can turn the organ cirrhotic, very damaged, leading to tumors or liver failure.”
“Hepatitis can be asymptomatic even when it is very serious, maybe you feel tired, a little nausea – adds Professor Aghemo – When the typical symptoms of liver patients appear, such as jaundice or ascites, it means that the liver is already in a dramatic condition “. This pathology is also identified with a simple blood test, starting with the transaminases which, if moved, indicate that there is some liver problem. “At that point, it’s best to go deeper with a search in the blood for proteins produced by the virus itself.”
Prevention
In Italy, Delta hepatitis is not very widespread thanks to vaccination against hepatitis B. It is almost absent in the population from 0 to 45 years, while it is found in young people not born in Italy and in the over 45 age group. our country is not tested for hepatitis, which should be done and if the result is negative the person should be vaccinated “.
Limiting the spread is important. The first preventive behavior is the vaccine, which has no contraindication except for the elderly and for those with serious illnesses. The other preventive behaviors remain those of protected sexual intercourse and contact with infected blood. “
“Until now the only drug for the treatment of Delta hepatitis was interferon, with many side effects and not usable on some subjects, which allowed 10 percent of patients to heal. bulevirtide it is specific for this infection – explains Professor Aghemo – is able to block the replication of the virus and normalize the tests. It is a drug that must be maintained, it must be done for one or two years, and to date we do not know what happens once it is suspended. The patient does not recover but improves because ‘by pausing the disease the liver regenerates itself “.
The bulevirtide it can be administered to patients who cannot be treated with interferon and becomes the only alternative to liver transplantation, allowing for a longer life.