{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T14:37:07Z","timestamp":1778164627269,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Bulevirtide (BLV) is an entry inhibitor blocking entry of HBsAg into hepatocytes by interfering with the bile acid transporter Na+\u2010taurocholate co\u2010transporting polypeptide. We here investigated if bile acid levels before or during BLV treatment would correlate with HDV RNA declines. We studied 20 patients with compensated HDV infection receiving a daily dose of 2\u00a0mg bulevirtide subcutaneously qd for at least 24\u2009weeks. ALT levels improved in all patients including 13\/20 patients showing normal ALT values at treatment Week 24. An HDV RNA drop of at least 50% was evident in 20\/20 patients at Week 24 including 10 patients showing a\u2009\u2265\u20092 log HDV RNA decline. Elevated bile acid levels were detected already before treatment in 10 patients and further increased during BLV administration with different kinetics. Baseline bile acids were associated with higher transient elastography values (<jats:italic>p<\/jats:italic>\u00a0=\u2009.0029) and evidence of portal hypertension (<jats:italic>p<\/jats:italic>\u00a0=\u2009.0004). Bile acid levels before treatment were associated with HDV RNA declines throughout therapy, but not at Week 24 (rho\u00a0=\u00a0\u22120.577; <jats:italic>p<\/jats:italic>\u00a0=\u2009.0078; rho\u00a0=\u00a0\u22120.635, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0026; rho\u00a0=\u00a0\u22120.577, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0077; rho\u00a0=\u00a0\u22120.519, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0191; rho\u00a0=\u00a0\u22120.564, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0119 and rho\u00a0=\u00a0\u22120.393, <jats:italic>p<\/jats:italic>\u00a0=\u2009.087 at treatment Weeks 2, 8, 12, 16, 20 and 24, respectively). However, bile acid increases during treatment were not associated with HDV RNA or ALT declines at any of the time points. BLV\u2010induced increases in bile salts do not correlate with HDV RNA declines suggesting that the inhibitory effects of BLV on NTCP differ between blocking bile acid transport and hindering HBsAg entry. If baseline bile salt levels could be useful to predict virological response remains to be confirmed.<\/jats:p>","DOI":"10.1111\/jvh.13831","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T09:59:37Z","timestamp":1678960777000},"page":"597-606","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Bile acid increase during bulevirtide treatment of hepatitis D is not associated with a decline in <scp>HDV RNA<\/scp>"],"prefix":"10.1111","volume":"30","author":[{"given":"Katja","family":"Deterding","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengjian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover 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Infection Medicine CiiM, a joint venture between Hannover Medical School and the Helmholtz Center for Infection Research  Hannover Germany"},{"name":"TWINCORE, a joint venture between the Helmholtz\u2010Centre for Infection Research (HZI) and the Hannover Medical School (MHH)  Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Maasoumy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover Germany"},{"name":"German Centre for Infection Research (DZIF)  Hannover\u2010Braunschweig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-8001","authenticated-orcid":false,"given":"Markus","family":"Cornberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover Germany"},{"name":"Center for Individualized 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