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. 2021 Apr 16;13:461–468. doi: 10.2147/JEP.S235550

Table 1.

New Drugs for Antiviral Treatment in Chronic HDV Infection

Compound Target Phase of Development Comments/Data
Bulevirtide (entry inhibitor) NCTP (Sodium taurocholate co-transporting polypeptide) receptor antagonist Phase III

  • Subcutaneous application
Conditional approval by EMA

  • Overall, well tolerated

  • Increase of bile acids, local side reactions

  • Monotherapy: Decline of serum HDV RNA and ALT normalization, no effect on HBsAg21

  • Combination (pegIFNa): stronger effect on HDV RNA and HBsAg22
Lonafarnib (prenylation inhibitor) Farnesyltransferase inhibitor Phase III

  • Oral application

  • Boosting with ritonavir reduces side effects (GI side effects)27

  • Monotherapy: HDV RNA decline, no effect on HBsAg

  • Combination (pegIFNa): stronger effect on HDV RNA

  • Viral and biochemical flares post-treatment are associated with HDV RNA and ALT response28
Pegylated interferon-lambda Immune modulation Phase II

  • Subcutaneous application
Induction of ISG

  • Less side effects than pegIFNa

  • ALT flares on treatment35
REP 2139 (nucleic acid polymers) Amphipathic alpha-helices in Class I surface glycoproteins Phase II

  • Intravenous application

  • ALT flares in combination with TDF and pegIFNa

  • Strong effect on HDV RNA and HBsAg38

  • So far only data from 12 patients
JNJ-3989 Ribonucleic acid interference Phase II

  • Subcutaneous application

  • Injection side irritations

  • No results regarding HDV treatment so far