Treatment response to bulevirtide is linked to amelioration of portal hypertension in patients with chronic hepatitis D
Portal hypertension is the main mechanism driving clinical deterioration in patients with compensated advanced chronic liver disease, for which patients with chronic hepatitis D (CHD) are at particularly high risk. This study demonstrates that in patients with CHD with portal hypertension, achieving response to antiviral treatment with bulevirtide decreases the hepatic venous pressure gradient (HVPG). Importantly, a clinical meaningful reduction in HVPG was observed only in treatment responders as defined by endpoints used in clinical trials, in particular, in all patients achieving combined response. Biomarkers of important pathophysiological mechanisms were also improved. The finding of a clinical meaningful HVPG decline in patients with CHD responding to antiviral treatment strengthens the clinical significance of the suggested on-treatment response criteria, supporting a disease-modifying effect of BLV response, likely translating into decreased morbidity and mortality in patients with CHD.
Authors
- Mattias Mandorfer (ORCID: https://orcid.org/0000-0003-2330-0017)
- Markus Cornberg (ORCID: https://orcid.org/0000-0002-9141-8001)
- Michael Schwarz (ORCID: https://orcid.org/0000-0002-2587-1385)
- Birgit Bremer (ORCID: https://orcid.org/0000-0002-1239-6968)
- Lukas Hartl (ORCID: https://orcid.org/0000-0003-3398-6120)
- Benjamin Maasoumy (ORCID: https://orcid.org/0000-0002-3250-3177)
- Christine S. Falk (ORCID: https://orcid.org/0000-0003-1376-7318)
- Tammo Lambert Tergast (ORCID: https://orcid.org/0000-0003-3908-6297)
- Lisa Sandmann (ORCID: https://orcid.org/0000-0003-4425-2640)
- Heiner H. Wedemeyer (ORCID: https://orcid.org/0000-0003-2906-0480)
- Thomas Reiberger (ORCID: https://orcid.org/0000-0002-4590-3583)
- Benedikt Silvester Hofer (ORCID: https://orcid.org/0000-0003-3403-3372)
- Albert Friedrich Stättermayer (ORCID: https://orcid.org/0000-0003-0737-4091)
- Mathias Jachs (ORCID: https://orcid.org/0000-0003-2871-4147)
- Katja Deterding
- Michael A Trauner (ORCID: https://orcid.org/0000-0002-1275-6425)
- Lorenz Balcar (ORCID: https://orcid.org/0000-0002-6708-3061)
- Julius F. M. Egge (ORCID: https://orcid.org/0009-0000-9651-5401)
- Martin Kabelitz
Institutions
- Medizinische Hochschule Hannover (DE)
- German Center for Infection Research (DE)
- Centre for Individualised Infection Medicine (DE)
- Medical University of Vienna (AT)
Publication Details
- Journal
- JHEP Reports
- Published
- 2025-10-18
- DOI
- https://doi.org/10.1016/j.jhepr.2025.101643
- Primary Topic
- Liver Disease and Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 0.00