P37 | Bulevirtide treatment for chronic HDV hepatitis: single-center experience

Premises and Purpose of the study: HDV is a RNA virus that uses HBsAg as own viral envelope and is estimated to infect about 15-20 million persons worldwide. Bulevirtide (BLV) is a novel therapy for chronic HDV infection that binds the NCTP receptor and blockes the entry of HDV in hepatocytes. The aim of this study is to evaluate the effectiveness of BLV in the real field of clinical practice.Materials and Methods: From June 2023 to December 2023 10 patients with HBV-HDV chronic hepatitis were enrolled. All patients received Bulevirtide 2 mg/day subcutaneously in the center of the Emergency and Highly Contagious Unit, Cotugno Hospital, Naples. All patients were Italian natives resident in Campania region. Blood specimens were collected for HDV-RNA, AST, ALT, PLT, globulins at baseline and after 6 months of BLV treatment.Results: 8 patients were males and 2 patients were female, mean age was 57 (range 51-67). 9 patients were cirrhotics and 5 of them showed clinically significative portal hypertension. All patients showed elevated ALT levels and serum HDV-RNA detectable at baseline, with high levels of viremia (>10000 cp/ml) in 8 of them. At 6 months of BLV treatment, HDVRNA was below low limit of detection in 8 patients and below low limit of quantification in the other 2. All patients except one showed a prompt early decline within the normal values of ALT, while all presented a delayed strong progressive decrease of serum HDV-RNA.Conclusions: Bulevirtide in our experience was highly effective as antiviral both in reducing liver necroinflammation and the viral load too.