On 6 and 7 October, the Lombard capital hosts the Delta Cure International Meeting, the first international congress on the treatment of HDV infection, an important and expected event to take stock of the most aggressive form of chronic viral hepatitis. There are between 10 and 20 million patients suffering from chronic hepatitis D in the world and about 10 thousand of them are in Italy. Until just a few months ago, a specific and effective drug therapy was not available for these people, but today – thanks to the progress in research and the encouraging results obtained from the experimentation – there are therapeutic innovations that could be able to modify the natural course of the disease. These innovations are at the center of the discussion at the first International Congress for the treatment of delta hepatitis, organized by Pietro Lampertico, full professor of gastroenterology at the University of Milan and director of the gastroenterology and hepatology unit of the Milan Polyclinic. Our country’s commitment in the field of research for the treatment of delta hepatitis is closely linked with the discovery, in 1977, of the HDV virus, responsible for this aggressive form of hepatitis, by the Italian researcher and professor Mario Rizzetto, who will be awarded during the congress for his pioneering research. In all these years, moreover, Italian research has continued to play a very important role by expanding knowledge on the virus, its epidemiology and natural history but above all by taking part in the trials – among the first countries in the world – of new anti-hepatitis drugs. delta. “The choice of Milan is in fact not accidental, not only for historical reasons but also of great relevance – declares Lampertico – In the last two years, together with our German colleagues and Professor Heiner Wedemeyer, we have been the first to demonstrate the effectiveness and the safety of a new drug for the treatment of delta hepatitis, bulevirtide. Specifically, we were the first to demonstrate the effectiveness of the treatment at one year and three years, to demonstrate its effectiveness in Italian patients with advanced disease, and, in the near future, we will also publish the first case in the world of recovery from Delta hepatitis thanks to this drug “, explains Lampertico. Those presented during the first Delta Cure International Meeting were surprising, also in light of the complexity and aggressiveness of the HDV virus. It is in fact a very particular pathogen: it is a defective virus, that it needs a portion of another virus, that of hepatitis B, to be able to replicate. “When we talk about patients with delta hepatitis, therefore, we always talk about people who already have another viral hepatitis, hepatitis B. Worldwide it is believed that about 5% of all subjects with hepatitis B also have delta hepatitis, in absolute numbers between ten and twenty million – explains the director of the Gastroenterology and Hepatol Unit gia del Policlinico di Milano – Delta hepatitis also has another characteristic, linked to the natural history of the infection: this form of hepatitis is extremely aggressive. The likelihood that patients with delta hepatitis will develop cirrhosis, hepatic decompensation, liver failure, primary liver cancer or have to be transplanted is much higher than in patients who have hepatitis B alone or, for example, by comparison , hepatitis C alone “. “In the face of this aggressive disease, medicine has long been without tools: in the last thirty years we have not had any specifically dedicated drugs, approved by the FDA or EMA, for this disease – Lampertico emphasizes – The great novelty of the latter two years, but especially in the last year, is the availability, for the first time in Europe, of a drug approved by Ema, which is called bulevirtide, which is an entry inhibitor, which blocks the entry of the delta virus inside liver cells. During the congress we will talk about this drug, but also about ongoing phase 3 studies with other drugs with a different mechanism of action, and therefore potentially complementary. And then there are molecules under study for monoinfected Hbv patients that could also be effective in patients with delta hepatitis. ”The Congress therefore represents a unique opportunity to present the news in all fields related to delta hepatitis, including diagnostics. “Unfortunately, the test with which the circulating genomic material of the HDV virus (HDV RNA) is identified is not widespread throughout the territory and is currently only possible in some centers in Italy; moreover, not all HBsAg positive patients are checked for the presence of the Delta hepatitis virus by searching for anti-HDVs – concludes Lampertico – This is why it is important, also from a diagnostic point of view, to share all the available information and the need for a more accurate diagnosis. Precisely the goal we want to achieve with this congress “.