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Off\u2010label pegylated interferon alpha was the primary treatment option in Europe prior to the introduction of bulevirtide, a first\u2010in\u2010class HDV entry inhibitor. This review aimed to describe practical learnings around the management of CHD and strategies for supporting patients since bulevirtide 2\u2009mg became the first approved treatment option in Europe. Since bulevirtide's approval, there has been an increased urgency to connect patients to care and real\u2010world evidence has accumulated, underscoring the importance of reflex testing, increased awareness of HDV among doctors, and harmonization of universal screening guidelines in Europe to facilitate care for patients early in the disease course. Discussions with patients have shifted from preparing for disease progression to living with a long\u2010term, daily treatment regimen, and clinical experience provides insight into best practices for navigating these conversations; it is critical for doctors to set evidence\u2010based treatment expectations and provide ongoing guidance and support to patients. Real\u2010world evidence demonstrates high treatment adherence and persistence; these studies and clinical trial data also indicate that long\u2010term bulevirtide monotherapy is safe and effective, even in patients with compensated cirrhosis, may improve liver fibrosis measurements, and potentially reduce the risk of liver\u2010related events and decompensation, which are important motivators for patients. Future research is needed to establish the safety and effectiveness of bulevirtide in certain special populations and determine the optimal treatment duration.<\/jats:p>","DOI":"10.1111\/liv.70757","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:38:57Z","timestamp":1782455937000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["From Diagnosis to Durability: A Review of the European Bulevirtide Experience and Practical Learnings for\n                    <scp>CHD<\/scp>\n                    Management"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-4522","authenticated-orcid":false,"given":"Monica","family":"Radu","sequence":"first","affiliation":[{"name":"National Institute for Infectious Diseases \u201cProf. Dr. Matei Bals\u201d  Bucharest 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