A 3-year course of bulevirtide monotherapy may cure HDV infection in patients with cirrhosis

Bulevirtide recently received conditional approval from the EMA for the treatment of chronic hepatitis delta, but the ideal duration of therapy is unknown. Herein, we describe the first case of hepatitis delta cure following 3 years of bulevirtide monotherapy in a patient with compensated cirrhosis and esophageal varices. During the 72-week off-bulevirtide follow-up, virological and biochemical responses were maintained. In the off-therapy liver biopsy, intrahepatic HDV RNA and hepatitis D antigen were undetectable, <1% of hepatocytes were hepatitis B surface antigen positive and all were negative for hepatitis B core antigen. Ishak grading and staging were improved following treatment.(c) 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Automated summary

Bulevirtide has received conditional approval from the EMA for treating chronic hepatitis delta, but the optimal duration of therapy remains unknown. In this study, a patient with compensated cirrhosis and esophageal varices achieved hepatitis delta cure after 3 years of bulevirtide monotherapy. Virological and biochemical responses were maintained during the 72-week off-therapy follow-up, and significant improvements were observed in liver biopsy results.