{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:16:13Z","timestamp":1790712973727,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["Restricted grant to TR"],"award-info":[{"award-number":["Restricted grant to TR"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Bulevirtide (BLV) blocks the uptake of the hepatitis D virus (HDV) into hepatocytes via the sodium\/bile acid cotransporter NTCP. BLV was conditionally approved by the EMA but real\u2010life data on BLV efficacy are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were treated with BLV monotherapy. Patients who did not achieve further decreases in HDV\u2010RNA after 24\u2009weeks were offered PEG\u2010IFN as an add\u2010on therapy in a response\u2010guided manner.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three patients (m: 10, f: 13; mean age: 47.9\u2009years, cirrhosis: 16; median ALT: 71\u2009IU\/ml; median HDV\u2010RNA: 2.1\u2009\u00d7\u200910<jats:sup>5<\/jats:sup>copies\/ml) started BLV monotherapy (2\u00a0mg\/day: 22; 10\u00a0mg\/day: 1). Twenty\u2010two completed \u226524\u2009weeks of treatment (24\u2013137\u2009weeks): Ten (45%) were classified as BLV responders at week 24. BLV was stopped in two patients with &gt;6\u2009months HDV\u2010RNA undetectability, but both became HDV\u2010RNA positive again. One patient was transplanted at week 25. One patient terminated treatment because of side effects at week 60. Ten patients are still on BLV monotherapy. Adding PEG\u2010IFN in eight patients induced an HDV\u2010RNA decrease in all (1.29\u2009\u00b1\u20090.19 [SD] log within 12\u2009weeks). HDV\u2010RNA decreased by &gt;2log or became undetectable in 45%(10\/22), 55%(11\/20), 65% (13\/20) and 69% (9\/13); and ALT levels normalised in 64% (14\/22), 85% (17\/20), 90% (18\/20) and in 92% (12\/13) patients at weeks 24, 36, 48 and 60, respectively. Portal pressure decreased in 40% (2\/5) of patients undergoing repeated measurement under BLV therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long\u2010term BLV monotherapy is safe and effectively decreases HDV\u2010RNA and ALT\u2014even in patients with cirrhosis. The optimal duration of BLV treatment alone or in combination with PEG\u2010IFN remains to be established. An algorithm for a response\u2010guided BLV treatment approach is proposed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16945","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T04:10:57Z","timestamp":1651810257000},"page":"144-154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Response\u2010guided long\u2010term treatment of chronic hepatitis D patients with bulevirtide\u2014results of a \u201creal world\u201d study"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2871-4147","authenticated-orcid":false,"given":"Mathias","family":"Jachs","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Rare Liver Disease (RALID) Center of the European Reference Network for Rare Hepatological Diseases (ERN RARE\u2010LIVER) Medical 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