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Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...
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HERACLIS_BLV_D: Increasing Response Rates During 2-Year Bulevirtide Real-Life Therapy in Chronic Hepatitis D.

Margarita Papatheodoridi1, Vasilios Sevastianos2, Kalliopi Zachou3

  • 1General Hospital of Athens "Laiko", Medical School of National and Kapodistrian University of Athens, Athens, Greece.

Liver International : Official Journal of the International Association for the Study of the Liver
|June 16, 2025
PubMed
Summary

Bulevirtide (BLV) monotherapy shows significant efficacy and safety in chronic hepatitis D (CHD) patients. Up to 2-year treatment led to high rates of virological and biochemical response, with no serious adverse events observed.

Keywords:
biochemical responsebulevirtidehepatitis Dvirological response

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Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Limited real-world data exists for bulevirtide (BLV) in chronic hepatitis D (CHD) treatment.
  • Assessing long-term efficacy and safety of BLV in a real-world clinical setting is crucial.

Purpose of the Study:

  • To evaluate the efficacy and safety of bulevirtide (BLV) therapy up to 2 years in Greek patients with chronic hepatitis D (CHD).
  • To determine virological and biochemical response rates and identify factors associated with treatment success.

Main Methods:

  • Retrospective analysis of 76 CHD patients receiving BLV 2 mg.
  • Serum HDV RNA levels measured by PCR; virological response (VR) defined as undetectable HDV RNA or >2 log10 decline.
  • Biochemical response (BR) defined as normal ALT levels.

Main Results:

  • At 24 months, VR rates reached 93%, HDV RNA undetectability 80.4%, BR 74%, and combined response 74%.
  • Lower baseline HDV RNA and platelets were associated with 24-month HDV RNA undetectability.
  • Lower baseline GGT and hemoglobin levels correlated with 24-month BR and combined responses.

Conclusions:

  • Bulevirtide (BLV) monotherapy is safe and effective for treating chronic hepatitis D (CHD).
  • Treatment demonstrated increasing rates of virological response, HDV RNA undetectability, and biochemical response over 2 years.
  • High response rates exceeding 90%, 80%, and 70% were achieved at 2 years, supporting BLV's role in CHD management.