Improvement of clinical parameters in HDV patients with advanced compensated cirrhosis treated with Bulevirtide monotherapy for 48 weeks

• Published in: Digestive and liver disease 2023-03, Vol.55, p.S29-S29
• Main Authors: Degasperi, E., Anolli, M.P., Renteria, S.C. Uceda, Sambarino, D., Borghi, M., Perbellini, R., Facchetti, F., Loglio, A., Monico, Sara, Fraquelli, M., Costantino, A., Ceriotti, F., Lampertico, P.
• Format: Article
• Language: English
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2023.01.053

Bulevirtide (BLV) has been conditionally approved for treatment of compensated chronic hepatitis Delta in Europe, however long-term outcomes of HDV patients with compensated cirrhosis treated with BLV monotherapy are currently unknown. Consecutive HDV patients with compensated cirrhosis who received BLV monotherapy for 48 weeks were enrolled in this single-center study. Clinical variables were collected at baseline, weeks 4, 8 and every 8 weeks thereafter. 20 Caucasian patients under nucleos(t)ide analogue (NUC) treatment were included: median age 49 years, 65% males, liver stiffness measurement (LSM) 16.8 kPa, 80% with varices. At baseline, ALT levels were 110 U/L, AST 92 U/L, GGT 52 U/L, albumin 3.9 g/dL, platelets 72 × 103/mm3, IgG 2285 mg/dL, HDV RNA 4.9 UI/mL. CPT score was A in all patients. Following 48 weeks of BLV monotherapy (2 mg/day in n=18 and 10 mg/day in n=2), HDV RNA declined by 3.1 Log IU/mL and became undetectable in 39%; 89% of patients achieved a virological response (undetectable HDV RNA or ≥2 Log decline vs. baseline). At week 48, most biochemical parameters improved: ALT (normalizing in 85% of patients), AST, GGT, IgG and albumin (p