{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:48:28Z","timestamp":1789541308554,"version":"build-2803163510"},"reference-count":83,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>More than 12 million individuals worldwide are chronically infected with the hepatitis D virus (HDV). HDV infection is the most severe form of viral hepatitis since it requires hepatitis B virus co-infection and accelerates progression to cirrhosis and hepatocellular carcinoma. Therefore, treatment modalities to slow the progression of the disease are essential but not yet available. In addition, no antiviral treatment to date has been shown to reliably eradicate HDV. Pegylated interferon (PEG-IFN) is the only universally used treatment to suppress HDV RNA replication and improve liver inflammation and fibrosis. This treatment can be completed in 12\u201318 months, but cure rates remain low, and success does not reliably increase with the addition of a nucleos(t)ide analog. PEG-IFN therapy is also limited by poor tolerability and multiple adverse effects, including neutropenia, thrombocytopenia, and neuropsychiatric symptoms. Newer antiviral therapies in development target unique aspects of HDV viral replication and show promising results in combination with PEG-IFN for long-term HDV RNA suppression. These newer antiviral therapies include buleviritide (which blocks HDV entry), lonafarnib (which prevents HDV assembly), and REP-2139 (which prevents HDV export). In this manuscript, we discuss the characteristics of HDV infection and review the new antiviral therapies approved for treatment and those under investigation.<\/jats:p>","DOI":"10.3390\/microorganisms12112177","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T06:29:57Z","timestamp":1730183397000},"page":"2177","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Chronic Hepatitis D Virus Infection and Its Treatment: A Narrative Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1346-9388","authenticated-orcid":false,"given":"Poonam","family":"Mathur","sequence":"first","affiliation":[{"name":"Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6045-6884","authenticated-orcid":false,"given":"Arshi","family":"Khanam","sequence":"additional","affiliation":[{"name":"Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7471-0812","authenticated-orcid":false,"given":"Shyam","family":"Kottilil","sequence":"additional","affiliation":[{"name":"Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jhep.2020.04.008","article-title":"The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis","volume":"73","author":"Stockdale","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1136\/gut.18.12.997","article-title":"Immunofluorescence detection of new antigen-antibody system (delta\/anti-delta) associated to hepatitis B virus in liver and in serum of HBsAg carriers","volume":"18","author":"Rizzetto","year":"1977","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jvh.13797","article-title":"Delta hepatitis epidemiology and the global burden of disease","volume":"30","author":"Kushner","year":"2023","journal-title":"J. Viral Hepat."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1093\/infdis\/jiz633","article-title":"Estimating the Global Prevalence, Disease Progression, and Clinical Outcome of Hepatitis Delta Virus Infection","volume":"221","author":"Miao","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1136\/gutjnl-2020-323888","article-title":"Hepatitis D virus in 2021: Virology, immunology and new treatment approaches for a difficult-to-treat disease","volume":"70","author":"Urban","year":"2021","journal-title":"Gut"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/apt.15521","article-title":"Long-term clinical outcomes in patients with chronic hepatitis delta: The role of persistent viraemia","volume":"51","author":"Palom","year":"2020","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.jhep.2020.02.030","article-title":"Chronic hepatitis D and hepatocellular carcinoma: A systematic review and meta-analysis of observational studies","volume":"73","author":"Alfaiate","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/JCMA.0000000000000606","article-title":"Hepatitis D virus dual infection increased the risk of hepatocellular carcinoma compared with hepatitis B virus mono infection: A meta-analysis","volume":"85","author":"Chang","year":"2022","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1111\/jvh.13577","article-title":"Risk of hepatocellular carcinoma in hepatitis B and D virus co-infected patients: A systematic review and meta-analysis of longitudinal studies","volume":"28","author":"Kamal","year":"2021","journal-title":"J. Viral Hepat."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jhep.2016.10.007","article-title":"Hepatitis delta-associated mortality in HIV\/HBV-coinfected patients","volume":"66","author":"Beguelin","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/liv.14833","article-title":"Is hepatitis delta underestimated?","volume":"41","author":"Papatheodoridi","year":"2021","journal-title":"Liver Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/j.jhep.2021.01.014","article-title":"The changing context of hepatitis D","volume":"74","author":"Rizzetto","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1136\/gutjnl-2018-316601","article-title":"Prevalence and burden of hepatitis D virus infection in the global population: A systematic review and meta-analysis","volume":"68","author":"Chen","year":"2019","journal-title":"Gut"},{"key":"ref_14","first-page":"232","article-title":"Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories","volume":"80","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1053\/j.gastro.2010.04.052","article-title":"Hepatitis B surface antigen serum levels help to distinguish active from inactive hepatitis B virus genotype D carriers","volume":"139","author":"Brunetto","year":"2010","journal-title":"Gastroenterology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1002\/hep.29800","article-title":"Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance","volume":"67","author":"Terrault","year":"2018","journal-title":"Hepatology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1111\/jvh.13512","article-title":"Epidemiology estimates of hepatitis D in individuals co-infected with human immunodeficiency virus and hepatitis B virus, 2002\u20132018: A systematic review and meta-analysis","volume":"28","author":"Shen","year":"2021","journal-title":"J. Viral Hepat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100547","DOI":"10.1016\/j.jhepr.2022.100547","article-title":"Implementation of anti-HDV reflex testing among HBsAg-positive individuals increases testing for hepatitis D","volume":"4","author":"Palom","year":"2022","journal-title":"JHEP Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"666","DOI":"10.4254\/wjh.v5.i12.666","article-title":"Life cycle and pathogenesis of hepatitis D virus: A review","volume":"5","author":"Abbas","year":"2013","journal-title":"World J. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.coviro.2016.01.022","article-title":"Pathogenesis by subviral agents: Viroids and hepatitis delta virus","volume":"17","author":"Flores","year":"2016","journal-title":"Curr. Opin. Virol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e00049","DOI":"10.7554\/eLife.00049","article-title":"Sodium taurocholate cotransporting polypeptide is a functional receptor for human hepatitis B and D virus","volume":"1","author":"Yan","year":"2012","journal-title":"Elife"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1002\/hep4.1951","article-title":"HBsAg isoform dynamics during NAP-based therapy of HBeAg-negative chronic HBV and HBV\/HDV infection","volume":"6","author":"Bazinet","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jhep.2023.05.001","article-title":"EASL Clinical Practice Guidelines on hepatitis delta virus","volume":"79","author":"Brunetto","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1136\/gutjnl-2017-314713","article-title":"Hepatitis delta virus persists during liver regeneration and is amplified through cell division both in vitro and in vivo","volume":"68","author":"Giersch","year":"2019","journal-title":"Gut"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"a021568","DOI":"10.1101\/cshperspect.a021568","article-title":"Hepatitis D Virus Replication","volume":"5","author":"Taylor","year":"2015","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/apt.16485","article-title":"One-quarter of chronic hepatitis D patients reach HDV-RNA decline or undetectability during the natural course of the disease","volume":"54","author":"Palom","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.jhep.2019.12.028","article-title":"Hepatitis delta genotype 5 is associated with favourable disease outcome and better response to treatment compared to genotype 1","volume":"72","author":"Spaan","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1001\/jama.2018.3795","article-title":"Chronic Hepatitis B Infection: A Review","volume":"319","author":"Tang","year":"2018","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jfma.2020.10.002","article-title":"Role of hepatitis D virus in persistent alanine aminotransferase abnormality among chronic hepatitis B patients treated with nucleotide\/nucleoside analogues","volume":"120","author":"Jang","year":"2021","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1111\/jvh.13366","article-title":"Ten-year follow-up of a randomized controlled clinical trial in chronic hepatitis delta","volume":"27","author":"Wranke","year":"2020","journal-title":"J. Viral Hepat."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1002\/hep.31214","article-title":"Long-Term Study of Hepatitis Delta Virus Infection at Secondary Care Centers: The Impact of Viremia on Liver-Related Outcomes","volume":"72","author":"Kamal","year":"2020","journal-title":"Hepatology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.dld.2022.11.003","article-title":"Highly dynamic changes of regional HBV epidemiology over two decades","volume":"55","author":"Ricco","year":"2023","journal-title":"Dig. Liver Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1053\/j.gastro.2009.01.052","article-title":"A 28-year study of the course of hepatitis Delta infection: A risk factor for cirrhosis and hepatocellular carcinoma","volume":"136","author":"Romeo","year":"2009","journal-title":"Gastroenterology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/j.jhep.2020.06.038","article-title":"Origin, HDV genotype and persistent viremia determine outcome and treatment response in patients with chronic hepatitis delta","volume":"73","author":"Roulot","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/S0168-8278(87)80032-6","article-title":"Rapidly progressive HBsAg-positive hepatitis in Italy. The role of hepatitis delta virus infection","volume":"5","author":"Saracco","year":"1987","journal-title":"J. Hepatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1002\/hep.1840130305","article-title":"Hepatitis B virus replication modulates pathogenesis of hepatitis D virus in chronic hepatitis D","volume":"13","author":"Smedile","year":"1991","journal-title":"Hepatology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12072-015-9675-4","article-title":"Asian-Pacific clinical practice guidelines on the management of hepatitis B: A 2015 update","volume":"10","author":"Sarin","year":"2016","journal-title":"Hepatol. Int."},{"key":"ref_38","unstructured":"World Health Organization (2023, November 02). Hepatitis D. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-d."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1111\/apt.17878","article-title":"Liver stiffness measurement as a noninvasive method for the diagnosis of liver cirrhosis in patients with chronic hepatitis D virus infection","volume":"59","author":"Sandmann","year":"2024","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/liv.13205","article-title":"Non-invasive fibrosis score for hepatitis delta","volume":"37","author":"Lutterkort","year":"2017","journal-title":"Liver Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"104691","DOI":"10.1016\/j.antiviral.2019.104691","article-title":"The Delta-4 fibrosis score (D4FS): A novel fibrosis score in chronic hepatitis D","volume":"174","author":"Da","year":"2020","journal-title":"Antiviral Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1002\/hep.28772","article-title":"First international external quality assessment for hepatitis delta virus RNA quantification in plasma","volume":"64","author":"Brichler","year":"2016","journal-title":"Hepatology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/j.jhep.2018.12.022","article-title":"Treating chronic hepatitis delta: The need for surrogate markers of treatment efficacy","volume":"70","author":"Yurdaydin","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1111\/apt.13734","article-title":"HBsAg kinetics in chronic hepatitis D during interferon therapy: On-treatment prediction of response","volume":"44","author":"Niro","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S1473-3099(18)30663-7","article-title":"Peginterferon alfa-2a plus tenofovir disoproxil fumarate for hepatitis D (HIDIT-II): A randomised, placebo controlled, phase 2 trial","volume":"19","author":"Wedemeyer","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1093\/infdis\/jix656","article-title":"Interferon Treatment Duration in Patients With Chronic Delta Hepatitis and its Effect on the Natural Course of the Disease","volume":"217","author":"Yurdaydin","year":"2018","journal-title":"J. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/hep.27102","article-title":"Late HDV RNA relapse after peginterferon alpha-based therapy of chronic hepatitis delta","volume":"60","author":"Heidrich","year":"2014","journal-title":"Hepatology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1002\/hep.28876","article-title":"Antiviral treatment and liver-related complications in hepatitis delta","volume":"65","author":"Wranke","year":"2017","journal-title":"Hepatology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/apt.12788","article-title":"Long-term therapy of chronic delta hepatitis with peginterferon alfa","volume":"40","author":"Heller","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1056\/NEJMoa0912696","article-title":"Peginterferon plus adefovir versus either drug alone for hepatitis delta","volume":"364","author":"Wedemeyer","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1097\/HEP.0000000000000309","article-title":"Treatment of chronic hepatitis D with peginterferon lambda-the phase 2 LIMT-1 clinical trial","volume":"77","author":"Etzion","year":"2023","journal-title":"Hepatology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.jhep.2016.04.016","article-title":"Treatment of chronic hepatitis D with the entry inhibitor myrcludex B: First results of a phase Ib\/IIa study","volume":"65","author":"Bogomolov","year":"2016","journal-title":"J. Hepatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S1473-3099(22)00318-8","article-title":"Safety and efficacy of bulevirtide in combination with tenofovir disoproxil fumarate in patients with hepatitis B virus and hepatitis D virus coinfection (MYR202): A multicentre, randomised, parallel-group, open-label, phase 2 trial","volume":"23","author":"Wedemeyer","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1056\/NEJMoa2213429","article-title":"A Phase 3, Randomized Trial of Bulevirtide in Chronic Hepatitis D","volume":"389","author":"Wedemeyer","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1016\/S0618-8278(19)30141-0","article-title":"Final results of a multicenter, open-label phase 2 clinical trial (MYR203) to assess safety and efficacy of myrcludex B in cwith PEG-interferon Alpha 2a in patients with chronic HBV\/HDV co-infection","volume":"70","author":"Wedemeyer","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.jhep.2022.07.016","article-title":"Bulevirtide monotherapy for 48 weeks in patients with HDV-related compensated cirrhosis and clinically significant portal hypertension","volume":"77","author":"Degasperi","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1016\/S1473-3099(15)00074-2","article-title":"Oral prenylation inhibition with lonafarnib in chronic hepatitis D infection: A proof-of-concept randomised, double-blind, placebo-controlled phase 2A trial","volume":"15","author":"Koh","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1002\/hep.29658","article-title":"Optimizing lonafarnib treatment for the management of chronic delta hepatitis: The LOWR HDV-1 study","volume":"67","author":"Yurdaydin","year":"2018","journal-title":"Hepatology"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1002\/hep.32259","article-title":"A phase 2 dose-finding study of lonafarnib and ritonavir with or without interferon alpha for chronic delta hepatitis","volume":"75","author":"Yurdaydin","year":"2022","journal-title":"Hepatology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/S2468-1253(17)30288-1","article-title":"Safety and efficacy of REP 2139 and pegylated interferon alfa-2a for treatment-naive patients with chronic hepatitis B virus and hepatitis D virus co-infection (REP 301 and REP 301-LTF): A non-randomised, open-label, phase 2 trial","volume":"2","author":"Bazinet","year":"2017","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/hep4.1633","article-title":"Persistent Control of Hepatitis B Virus and Hepatitis Delta Virus Infection Following REP 2139-Ca and Pegylated Interferon Therapy in Chronic Hepatitis B Virus\/Hepatitis Delta Virus Coinfection","volume":"5","author":"Bazinet","year":"2021","journal-title":"Hepatol. Commun."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s11908-012-0307-z","article-title":"Treatment options for hepatitis delta virus infection","volume":"15","author":"Heidrich","year":"2013","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/apt.16408","article-title":"Durable virological response and functional cure of chronic hepatitis D after long-term peginterferon therapy","volume":"54","author":"Hercun","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"104995","DOI":"10.1016\/j.antiviral.2020.104995","article-title":"Effectiveness of pegylated interferon monotherapy in the treatment of chronic hepatitis D virus infection: A meta-analysis","volume":"185","author":"Abdrakhman","year":"2021","journal-title":"Antivir. Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0140-6736(10)61931-9","article-title":"Hepatitis delta virus","volume":"378","author":"Hughes","year":"2011","journal-title":"Lancet"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1111\/jvh.13439","article-title":"A transient early HBV-DNA increase during PEG-IFNalpha therapy of hepatitis D indicates loss of infected cells and is associated with HDV-RNA and HBsAg reduction","volume":"28","author":"Anastasiou","year":"2021","journal-title":"J. Viral Hepat."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Rong, Y., Ju, X., Sun, P., and Wang, Y. (2023). Comparative effectiveness of seven interventions for chronic hepatitis D: A systematic review and network meta-analysis of randomized controlled trials. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08718-7"},{"key":"ref_68","unstructured":"(2024, October 14). Eiger to Discontinue Phase 3 LIMT-2 Trial of Peginterferon Lambda in Patients with Chronic Hepatitis Delta. Available online: https:\/\/www.biospace.com\/eiger-to-discontinue-phase-3-limt-2-trial-of-peginterferon-lambda-in-patients-with-chronic-hepatitis-delta."},{"key":"ref_69","first-page":"291","article-title":"Safety and efficacy of bulevirtide monotherapy and in combination with peginterferon alfa-2a in patients with chronic hepatitis delta: 24 Weeks interim data of MYR204 phase 2b study","volume":"75","author":"Asselah","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1111\/liv.15602","article-title":"Quality-of-life scores improve after 96 weeks of PEG-IFNa-2a treatment of hepatitis D: An analysis of the HIDIT-II trial","volume":"43","author":"Dinkelborg","year":"2023","journal-title":"Liver Int."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.jhep.2024.05.001","article-title":"Bulevirtide monotherapy in patients with chronic HDV: Efficacy and safety results through week 96 from a phase III randomized trial","volume":"81","author":"Wedemeyer","year":"2024","journal-title":"J. Hepatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.jhep.2024.01.035","article-title":"Blocking viral entry with bulevirtide reduces the number of HDV-infected hepatocytes in human liver biopsies","volume":"80","author":"Allweiss","year":"2024","journal-title":"J. Hepatol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1056\/NEJMoa2314134","article-title":"Bulevirtide Combined with Pegylated Interferon for Chronic Hepatitis D","volume":"391","author":"Asselah","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.jhep.2021.10.012","article-title":"Safety and effectiveness of up to 3 years\u2019 bulevirtide monotherapy in patients with HDV-related cirrhosis","volume":"76","author":"Loglio","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"101070","DOI":"10.1016\/j.jhepr.2024.101070","article-title":"Effect of Peg-IFN on the viral kinetics of patients with HDV infection treated with bulevirtide","volume":"6","author":"Brichler","year":"2024","journal-title":"JHEP Rep."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.jhep.2023.04.027","article-title":"No virologic resistance to bulevirtide monotherapy detected in patients through 24 weeks treatment in phase II and III clinical trials for chronic hepatitis delta","volume":"79","author":"Hollnberger","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_77","unstructured":"Gilead Receives Complete Response Letter from, U.S. (2024, October 14). FDA for Bulevirtide for the Treatment of Adults with Hepatitis Delta Virus. Available online: https:\/\/www.gilead.com\/company\/company-statements\/2022\/gilead-receives-complete-response-letter-from-us-fda-for-bulevirtide-for-the-treatment-of-adults-with-hepatitis-delta-virus."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"100686","DOI":"10.1016\/j.jhepr.2023.100686","article-title":"Treating hepatitis D with bulevirtide\u2014Real-world experience from 114 patients","volume":"5","author":"Tacke","year":"2023","journal-title":"JHEP Rep."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"101057","DOI":"10.1016\/j.jhepr.2024.101057","article-title":"Treatment with bulevirtide in HIV-infected patients with chronic hepatitis D: ANRS HD EP01 BuleDelta and compassionate cohort","volume":"6","author":"Pol","year":"2024","journal-title":"JHEP Rep."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2364031","DOI":"10.1155\/2024\/2364031","article-title":"Long-Term Treatment with Bulevirtide in Patients with Chronic Hepatitis D and Advanced Chronic Liver Disease","volume":"2024","author":"Sapuk","year":"2024","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.gastha.2024.01.001","article-title":"Dynamics of Virological and Clinical Response Parameters of Bulevirtide Treatment for Hepatitis D: Real-World Data","volume":"3","author":"Killer","year":"2024","journal-title":"Gastro Hep Adv."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Buti, M., Calleja, J.L., Rodriguez, M.A., Dominguez-Hernandez, R., Cantero, H., Espinoza, N., and Casado, M.A. (2024). Clinical and economic value of bulevirtide in the treatment of chronic hepatitis D. Gastroenterol. Hepatol., 502241.","DOI":"10.1016\/j.gastrohep.2024.502241"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/hep4.1043","article-title":"Pharmacokinetics and pharmacodynamics modeling of lonafarnib in patients with chronic hepatitis delta virus infection","volume":"1","author":"Canini","year":"2017","journal-title":"Hepatol. Commun."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/11\/2177\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:23:04Z","timestamp":1760113384000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/11\/2177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,29]]},"references-count":83,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["microorganisms12112177"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms12112177","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,29]]}}}