Hepatitis D Virus and HBsAg Dynamics in the era of new Antiviral Treatments

Louis Shekhtman, Sarah Duehren, Ohad Etzion, Scott J. Cotler, Harel Dahari

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: Hepatitis D virus (HDV) infection is the most severe form of chronic viral hepatitis, with no FDA-approved therapy. Progress in the development of effective HDV treatments is accelerating. This review highlights how mathematical modeling is improving understanding of HDV-HBsAg-host dynamics during antiviral therapy and generating insights into the efficacy and modes of action (MOA) of new antiviral agents. Recent Findings: Clinical trials with pegylated-interferon-λ, bulevertide, nucleic acid polymers, and/or lonafarnib against various steps of the HDV-life cycle have revealed new viral-kinetic patterns that were not observed under standard treatment with pegylated-interferon-α. Modeling indicated that the half-lives of circulating HDV and HBsAg are ~ 1.7 d and ~ 1.3 d, respectively, estimated the relative response of HDV and HBsAg during different antiviral therapies, and provided insights into the efficacy and MOA of drugs in development for treating HDV, which can inform response-guided therapy to individualize treatment duration. Summary: Mathematical modeling of HDV and HBsAg kinetics provides a window into the HDV virus lifecycle, HDV-HBsAg-host dynamics during antiviral therapy, and the MOA of new drugs for HDV.

Original languageEnglish
Pages (from-to)401-412
Number of pages12
JournalCurrent Gastroenterology Reports
Issue number12
Early online date11 Oct 2023
StatePublished - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Bulevertide
  • Hepatitis D virus
  • Lonafarnib
  • Mathematical modeling
  • Nucleic acid polymers
  • Pegylated-interferon-α
  • Pegylated-interferon-λ
  • Response-guided therapy


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