{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:35:03Z","timestamp":1784543703555,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"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":["Liver International"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Data Availability Statement<\/jats:title>\n                    <jats:p>The data of this study can be available from the corresponding author upon reasonable request.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>There is still limited real\u2010life data for bulevirtide (BLV) therapy in chronic hepatitis D (CHD). We assessed the efficacy and safety of up to 2\u2010year BLV therapy in CHD patients treated at Greek centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All patients with CHD starting BLV 2\u2009mg before the approvals of the HERACLIS_BLV_D study were included. All patients were followed according to standard clinical practice. Serum HDV RNA was determined by a polymerase chain reaction assay at a central lab. Virological response (VR) was defined as HDV RNA undetectable or decline &gt;\u20092 log\n                      <jats:sub>10<\/jats:sub>\n                      compared to baseline. Biochemical response (BR) was defined as normal ALT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010six patients were included (45 with cirrhosis). At 12 and 24\u2009months, rates of VR were 73% and 93%, HDV DNA undetectability 57% and 80.4%, BR 71% and 74%, and combined response (VR\u2009+\u2009BR) 51% and 74%, respectively. VR response at month 24 was associated with no baseline characteristic, while 24\u2010month HDV RNA undetectability was independently associated with lower baseline HDV RNA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) and platelets (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). Both 24\u2010month BR and combined responses were independently associated with lower baseline gamma\u2010glutamyl transpeptidase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and haemoglobin levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). There was no drug\u2010related serious adverse event and no patient discontinued BLV due to an adverse event.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BLV monotherapy is safe and effective for the treatment of CHD patients followed at Greek tertiary liver centres offering increasing rates of VRHDV RNA undetectability and BR or combined response exceeding 90%, 80% and 70%, respectively, at 2\u2009years of therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70151","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T11:24:36Z","timestamp":1751023476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["HERACLIS_BLV_D: Increasing Response Rates During 2\u2010Year Bulevirtide Real\u2010Life Therapy in Chronic Hepatitis D"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8581-6591","authenticated-orcid":false,"given":"Margarita","family":"Papatheodoridi","sequence":"first","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National and 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  Kifissia Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3094-8209","authenticated-orcid":false,"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 and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Karagiannakis","sequence":"additional","affiliation":[{"name":"General Hospital of Athens \u201cLaiko\u201d Medical School of National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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"}]},{"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  Athens 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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 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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":"Nikolaos","family":"Psychos","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 and Kapodistrian University of Athens  Athens 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Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Global Hepatitis Report, 2017","author":"World Health 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and Economic Value of Bulevirtide in the Treatment of Chronic Hepatitis D","volume":"48","author":"Buti M.","year":"2025","journal-title":"Gastroenterology and Hepatology"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.04.027"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912696"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.16174"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.05.001"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000584"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.03.025"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2893.1998.00109.x"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.04.008"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.70151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/liv.70151","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.70151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:36:17Z","timestamp":1772958977000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.70151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":24,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/liv.70151"],"URL":"https:\/\/doi.org\/10.1111\/liv.70151","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]},"assertion":[{"value":"2025-02-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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