Viral hepatitis: A narrative review of hepatitis A–E

Table 5 Novel drug treatments for chronic hepatitis D virus

Drug	Mode of action	Administration route	Phase of study	Adverse effect
Myrcludex B	Interferes with hepatitis D virus entry into hepatocyte	Subcutaneous, daily for 6 mo	Ib, IIa	Lipase and amylase elevation in phase I but not in phase II study
	Through sodium taurocholate cotransporting	± pegylated interferon (Peg-IFN)		Elevation of taurine- and glycine-conjugated bile acids without apparent clinical consequences
	polypeptide inhibition			Thrombocytopenia, neutropenia, lymphopenia, and eosinophilia: Generally mild, transient
Lonafarnib	Farnesyltransferase inhibitor, inhibits virion assembly	Oral, 2 to 12 mo, ± ritonavir	II	Gastrointestinal toxicity (anorexia, nausea with or without vomiting, diarrhea, weight loss): Dose dependent and in lower dose cohorts generally mild and well tolerated
		± peg-IFN
Rep-2139-Ca	Nucleic acid polymer, binds with high affinity to	Intravenous infusion, once wkly	II	Hair loss, dysphagia, anorexia, dysgeusia, in hepatitis B study: Related to heavy metal exposure at the trial site
	Amphipathic proteins, which are required at various	for 4-6 mo ± peg-IFN		Administration route-related side effects: peripheral grade 1 hyperemia, fever, chills, and headache
	Stages of the viral life cycle

IFN: Interferon.