Rusch, Sophia and Stoeckert, Petra and Schmid, Stephan and Schilling, Tobias and Mueller, Martina (2025) A Decade of Bulevirtide Use in Chronic Hepatitis Delta: Real-World Clinical Results. JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES, 34 (4). pp. 467-473. ISSN 1841-8724, 1842-1121
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Background and Aims: Until recently, the only available treatment option for hepatitis D virus (HDV) was the off-label use of interferon, which is associated with limited efficacy and considerable side effects. The approval of the first HDV-direct antiviral, bulevirtide (BLV), has introduced a targeted therapeutic option for patients with chronic hepatitis delta. We assessed the clinical efficacy of BLV in our HDV patients. Methods: We conducted a retrospective analysis of all patients diagnosed with HDV infection in our department over the past 10 years. For statistical analysis, we performed multivariate analysis of variance, MANOVA. Results: 26 patients tested positive for HDV antibodies (17 developed chronic hepatitis delta). Eleven patients received BVD. At treatment initiation, liver cirrhosis was present in three patients in the bulevirtide group (MELD-Na: 9-10; Child-Pugh: 5-7) and in three patients in the no bulevirtide group (MELD-Na: 13-18; Child-Pugh: 5-8). Over 12 months of follow-up, bulevirtide recipients showed reductions in alanine aminotransferase (ALT; mean baseline 88 U/L vs 59 U/L; controls 230 U/L vs 206 U/L; MANOVA between-subject effect: p<0.05), aspartate aminotransferase (AST; 68 U/L vs 56 U/L; controls 208 U/L vs 151 U/L; p<0.05), bilirubin (0.74 mg/dL vs 0.65 mg/dL; controls 1.48 mg/dL vs 1.17 mg/dL; p<0.005), HDV-RNA (1,323,182 copies/mL vs 36,975 copies/mL; controls 416,825 copies/mL vs 17,914,733 copies/mL; p<0.05) a statistically significant time-by-group interaction was found for both Child-Pugh scores (p<0.0001) and MELD-Na scores (p<0.05), indicating improved liver function over time in the BLV group compared to controls. No progression of liver fibrosis was observed. Conclusions: Bulevirtide is a safe and effective treatment for chronic hepatitis delta in a real-world clinical setting. These findings support its role as a sustainable therapeutic option for patients with HDV infection.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; bulevirtide; hepatitis delta; viral hepatitis; real world data; therapeutic options |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Sep 2026 06:44 |
| Last Modified: | 23 Sep 2026 06:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/66542 |
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