{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:26:24Z","timestamp":1782491184512,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Daily subcutaneous bulevirtide (BLV) 2\u2009mg has been approved as first\u2010line treatment for chronic hepatitis D (CHD), but long\u2010term real\u2010world adherence data are limited. We assessed adherence rates during BLV therapy and their impact on treatment response. HERACLIS_BLV_D study (NCT05928000) included adult CHD patients initiating BLV 2\u2009mg\/day and followed in routine clinical practice. Virological response (VR) was defined as HDV RNA &lt;\u200957.5\u2009IU\/mL or decline &gt;\u20092 log\n                    <jats:sub>10<\/jats:sub>\n                    and biochemical response (BR) as normal ALT (\u2264\u200940\u2009IU\/L). Adherence was evaluated through the national prescription system based on executed monthly BLV prescriptions. Treatment discontinuation was defined as no executed BLV prescription for &gt;\u20093\u2009months at the end of follow\u2010up. Seventy\u2010six patients were included. VR\/BR rates were 73%\/71% at 12 and 93%\/74% at 24\u2009months. Thirteen (17%) patients discontinued BLV (none due to adverse events); 6%\u20137% per year. Mean adherence among treated patients was 98%\u2009\u00b1\u20096% in 1st year declining to 93%\u2009\u00b1\u200913% in 2nd and 91%\u2009\u00b1\u200917% in 3rd year (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009\u2264\u20090.010). No baseline characteristic was associated with poor (&lt;\u200990%) or good (\u2265\u200990%) adherence to BLV therapy. Patients with poor vs. good adherence had lower VR rates (1st year: 33% vs. 77%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.038; 2nd year: 60% vs. 97%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.030). In conclusion, in clinical practice, &lt;\u200910% of CHD patients discontinue BLV therapy annually. Adherence is excellent in the first year and remains &gt;\u200990% until the third year although gradually declines. Poor (&lt;\u200990%) adherence cannot be predicted but adversely affects the VR rates emphasizing the need for strategies to support long\u2010term treatment retention.\n                  <\/jats:p>","DOI":"10.1111\/jvh.70201","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T04:33:28Z","timestamp":1781930008000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["HERACLIS_BLV_D: Adherence to Real\u2010Life Therapy With Bulevirtide in Chronic Hepatitis D"],"prefix":"10.1111","volume":"33","author":[{"given":"Dimitra","family":"Lakiotaki","sequence":"first","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Papatheodoridi","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilios","family":"Sevastianos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cEvangelismos\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalliopi","family":"Zachou","sequence":"additional","affiliation":[{"name":"General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Christodoulou","sequence":"additional","affiliation":[{"name":"University General Hospital of Ioannina  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Koskinas","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Deutsch","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Alexopoulou","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8118-7190","authenticated-orcid":false,"given":"Ioannis","family":"Elefsiniotis","sequence":"additional","affiliation":[{"name":"General and Oncology Hospital of Kifisia \u201cAgioi Anargyroi\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Triantos","sequence":"additional","affiliation":[{"name":"University General Hospital of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Gigi","sequence":"additional","affiliation":[{"name":"General Hospital of Thessaloniki \u201cHippokratio\u201d Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-6230","authenticated-orcid":false,"given":"Theodoros","family":"Androutsakos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios S.","family":"Karagiannakis","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9971-5174","authenticated-orcid":false,"given":"Iliana","family":"Mani","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Dimitroulopoulos","sequence":"additional","affiliation":[{"name":"Agios Savvas Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mela","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cEvangelismos\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0923-050X","authenticated-orcid":false,"given":"Emmanouil","family":"Sinakos","sequence":"additional","affiliation":[{"name":"General Hospital of Thessaloniki \u201cHippokratio\u201d Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spyros","family":"Michopoulos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cAlexandras\u201d  Athina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Mimidis","sequence":"additional","affiliation":[{"name":"University General Hospital of Alexandroupolis  Alexandroupolis Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"General Army Hospital of Athens  Athina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Kontos","sequence":"additional","affiliation":[{"name":"Agios Savvas Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Veretanos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cEvangelismos\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Lymperopoulos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cEvangelismos\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Giannoulis","sequence":"additional","affiliation":[{"name":"General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilios","family":"Papadimitropoulos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evdoxia","family":"Avramopoulou","sequence":"additional","affiliation":[{"name":"University General Hospital of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkistis","family":"Papatheodoridi","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cAlexandras\u201d  Athina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spyridon","family":"Pantzios","sequence":"additional","affiliation":[{"name":"General and Oncology Hospital of Kifisia \u201cAgioi Anargyroi\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larisa","family":"Vasilieva","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hariklia","family":"Kranidioti","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Koullias","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Soukovelos","sequence":"additional","affiliation":[{"name":"University General Hospital of Ioannina  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Fytili","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3680-8194","authenticated-orcid":false,"given":"John","family":"Vlachogiannakos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Cholongitas","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spilios","family":"Manolakopoulos","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cHippokratio\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Goulis","sequence":"additional","affiliation":[{"name":"General Hospital of Thessaloniki \u201cHippokratio\u201d Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Dalekos","sequence":"additional","affiliation":[{"name":"General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3518-4060","authenticated-orcid":false,"given":"George","family":"Papatheodoridis","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National &amp; Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61931-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/13596535251349380"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00307-4"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15467"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2019.04.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.04.008"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.70056"},{"key":"e_1_2_9_9_1","unstructured":"Agency EM \u201cHepcludex \u201d(2020) https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/hepcludex."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.04.016"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.07.016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2023.100686"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16945"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(22)00540-2"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.70151"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.05.001"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2025.2578787"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.70097"},{"issue":"6","key":"e_1_2_9_19_1","first-page":"1012","article-title":"Real World Use of Bulevirtide: A Retrospective Study on Quality of Life Adherence and Safety in a Cohort of Adult Patients With Hepatitis Delta Virus","volume":"82","author":"Cadore A.","year":"2025","journal-title":"European Journal of Hospital Pharmacy"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.70404"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2213429"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2314134"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.12.044"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00318-8"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2024-332597"},{"issue":"1","key":"e_1_2_9_26_1","article-title":"Efficacy and Safety of 144\u2009Weeks of Bulevirtide 2 mg or 10 mg Monotherapy From the Ongoing Phase 3 Study MYR301","volume":"80","author":"Lampertico P.","year":"2024","journal-title":"Journal of Hepatology"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2025.106311"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70201","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jvh.70201","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:55:26Z","timestamp":1782449726000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.70201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/jvh.70201"],"URL":"https:\/\/doi.org\/10.1111\/jvh.70201","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"assertion":[{"value":"2026-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70201"}}