ArticleJHEP reports : innovation in hepatology2026
Treatment response to bulevirtide is linked to amelioration of portal hypertension in patients with chronic hepatitis D.
Article in JHEP reports : innovation in hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04863703 (Improvement of Portal Hypertension During Viral Suppression in Patients With Hepatitis Delta), which is not on this map. Cited by 1 paper.
What it found
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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.
Improvement of Portal Hypertension During Viral Suppression in Patients With Hepatitis Delta (IMPHROVE-D)
Who cites it
1 citing paper in PubMed.
- Future of Endoscopy in Surveillance of Esophageal Varices.Current gastroenterology reports · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: Portal hypertension (PH) drives decompensation in patients with advanced chronic liver disease. Effects of antiviral treatment with bulevirtide (BLV) and achievement of suggested treatment endpoints on PH in patients with chronic hepatitis D (CHD) are unknown. Methods: BLV-treated CHD patients with PH were prospectively enrolled in this observational, multicenter study. Hepatic venous pressure gradient (HVPG) was measured before (BL) and after ≥12 months of BLV treatment (M12). HVPG response (≥10% decline) rates were compared between virological (VR), biochemical (BR), and combined (CR) responders Results: Of 34 patients receiving BL HVPG measurement, 20 patients with paired HVPG measurement and a BL clinically significant portal hypertension (CSPH) (≥10 mmHg HVPG) prevalence of 85% were included. At M12, HVPG significantly decreased in patients with CR (n = 12; 15.5 [IQR 10.5-21.8] to 12 [IQR 7.3-15.8] mmHg; Conclusions: Significant HVPG decreases accompanied by improvement of bacterial translocation, (dys)angiogenesis/endothelial dysfunction and SI are observed in patients with CHD achieving BLV response. These findings provide evidence for the validity and clinical relevance of the currently recommended on-treatment response criteria. Clinical trials registration: This study is registered at ClinicalTrials.gov (NCT04863703). Impact and implications: 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.
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