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We performed a retrospective analysis of patients with CHD who received BLV 2\u2009mg\/day for &gt;12\u2009months at a tertiary center. Virological response (VR) was defined as a reduction in hepatitis delta virus\u2010ribonucleic acid (HDV\u2010RNA) \u22652 log<jats:sub>10<\/jats:sub> from baseline or HDV\u2010RNA negativity and biochemical response (BR) as gender\u2010specific normalization of transaminases. We identified 14 patients (9 men, 5 women; median age of 48\u2009years; interquartile range (IQR) of 37\u201355), of whom 12 (86%) had suggested or assumed ACLD according to Baveno VI criteria. The median duration of BLV treatment was 26\u2009months (IQR 17\u201327). During treatment, the mean HDV\u2010RNA level decreased from log<jats:sub>10<\/jats:sub> 5.58\u2009IU\/ml to levels between log<jats:sub>10<\/jats:sub> 2.19\u2009IU\/ml and log<jats:sub>10<\/jats:sub> 3.19\u2009IU\/ml. HDV\u2010RNA negativity was achieved in up to 63% after 24\u2009months. VR and BR were 86% and 43% after 12\u2009months, 90% and 60% after 18\u2009months, 75% and 75% after 24\u2009months, and 100% and 50% after 30\u2009months, respectively. Two nonpersisting viral breakthroughs were observed after 24\u2009months of treatment. The Child Pugh score and model of end\u2010stage liver disease (MELD) scores remained stable or improved in 12 patients (86%). Only one patient developed hepatic decompensation after 24\u2009months of treatment with ascites requiring large\u2010volume paracentesis which was not associated with viral breakthrough, portal vein thrombosis, or hepatocellular carcinoma. Treatment with BLV beyond one year is effective and safe for patients with CHD and ACLD. Liver function remained stable or improved during treatment in the vast majority of patients, and only one case of hepatic decompensation occurred during a median follow\u2010up of 26\u2009months.<\/jats:p>","DOI":"10.1155\/2024\/2364031","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T05:43:50Z","timestamp":1721713430000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long\u2010Term Treatment with Bulevirtide in Patients with Chronic Hepatitis D and Advanced Chronic Liver Disease"],"prefix":"10.1155","volume":"2024","author":[{"given":"Ayaz","family":"Sapuk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Steinhoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"H\u00fcnninghaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Willuweit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jassin","family":"Rashidi Alavijeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Hild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Asar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut H.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6752-0690","authenticated-orcid":false,"given":"Christoph","family":"Schramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.04.008"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-021-03478-8"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(10)61931-9"},{"key":"e_1_2_10_4_2","first-page":"743","article-title":"On behalf of the Baveno VI faculty. 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