ArticleJournal of viral hepatitis2025
Applying the COM-B Model to Identify Barriers to Bulevirtide Adherence in Chronic Hepatitis D: A Multicenter Italian Study.
Article in Journal of viral hepatitis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- From Diagnosis to Durability: A Review of the European Bulevirtide Experience and Practical Learnings for CHD Management.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- HERACLIS_BLV_D: Adherence to Real-Life Therapy With Bulevirtide in Chronic Hepatitis D.Journal of viral hepatitis · 2026Observational
- Applying the COM-B Model to Identify Barriers to Bulevirtide Adherence in Chronic Hepatitis D: A Multicenter Italian Study.Journal of viral hepatitis · 2025Article
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Authors and funding
5 authors.
Funding
Abstract
Adherence to treatment is a key determinant of clinical outcomes in chronic infectious diseases, including hepatitis D virus (HDV) infection. Even if bulevirtide (BLV) has shown a promising adherence profile in clinical trials, adherence is often compromised by various barriers in the context of HDV-especially among migrant populations. The aim of this study was to investigate the factors influencing adherence to BLV treatment in real-life settings in Italy. From May to September 2024, two anonymous surveys-one for HDV patients undergoing bulevirtide (BLV) treatment and one for their hepatologists-were conducted across five tertiary centers in Italy. The study employed the COM-B model (Capability, Opportunity, Motivation-Behaviour) to systematically explore the behavioural drivers influencing treatment adherence in this population and unmet needs. Of the 86 consecutive adult patients receiving bulevirtide (BLV) who were invited to participate, 83 (97%) completed the multilingual survey (35% > 60 years old, 48% Italians; 80% under BLV > 6 months) and were included in the analysis, together with 13 hepatologists. The findings revealed key challenges related to patient education, logistical access to medication, and psychological factors affecting motivation. Specifically, 10% had considered discontinuing treatment and 10% admitted to having missed doses. A deeper understanding of these multifactorial determinants may aid in the development of targeted interventions to enhance adherence and achieve personalized therapeutic outcomes for individuals living with HDV.
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