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Bulevirtide HDV Treatment — SCE Infectious Diseases MCQ

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HardHepatitisBulevirtide HDV TreatmentSCE Infectious Diseases

A 45-year-old man with known Hepatitis D co-infection (HDV RNA positive, HBsAg positive) on Tenofovir for HBV asks about specific HDV treatment. What agent has been recently approved for chronic HDV?

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Correct answer: E — Bulevirtide (Hepcludex) — an entry inhibitor that blocks HDV (and HBV) entry into hepatocytes via the NTCP receptor; it is the first approved specific HDV therapy

Bulevirtide (Hepcludex) was approved by the EMA in 2020 as the first specific treatment for chronic HDV infection. It is a lipopeptide that blocks the sodium taurocholate co-transporting polypeptide (NTCP) receptor — the entry receptor for both HDV and HBV. It is given as a daily subcutaneous injection. Pegylated Interferon-alpha remains an option (24–48 months) but has significant side effects. NUCs (Tenofovir, Entecavir) suppress HBV but have no direct activity against HDV. Bulevirtide is used in combination with ongoing NUC therapy for HBV.

Reference: EASL 2024 – Hepatitis D; EMA 2020 – Bulevirtide