Evidence map›Paper›PMID 42012135›Full record

ArticleAlimentary pharmacology & therapeutics2026

Correlation of Bile Acid Dynamics to Bulevirtide Response and Disease Severity in Patients With Hepatitis D.

Marlene Hintersteininger, Michael Schwarz, Philipp Schwabl, Lukas Hartl, Lorenz Balcar, Benedikt Silvester Hofer, Georg Kramer, Christian Sebesta, Paul Thöne, Patrik Attalla and 5 more

Abstract read
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Marlene HintersteiningerDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Michael SchwarzDivision of Gastroenterology and Hepatology, Department of Internal Medicine II, University Hospital of Sankt Pölten, Sankt Pölten, Austria.
Philipp SchwablDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Lukas HartlDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0003-3398-6120
Lorenz BalcarDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0002-6708-3061
Benedikt Silvester HoferDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0003-3403-3372
Georg KramerDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0009-0008-1736-3699
Christian SebestaDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0009-0001-7504-8506
Paul ThöneDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Patrik AttallaDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Michael GschwantlerDepartment of Internal Medicine IV, Klinik Ottakring, Vienna, Austria.
Michael TraunerDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Mattias MandorferDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0003-2330-0017
Thomas ReibergerDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0002-4590-3583
Mathias JachsDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0003-2871-4147

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBulevirtide (BLV) blocks hepatitis D virus (HDV) entry by targeting the sodium taurocholate co-transporting polypeptide (NTCP). This study assessed the relationship between bile acid (BA) levels and antiviral response to BLV.

methodsSerum BA levels were monitored in HDV-infected patients pre-, under, and post BLV treatment. Virologic response (VR) was defined by ≥ 2log

resultsTwenty five patients (48% male; advanced chronic liver disease [ACLD]: 92.0%, 17 patients with VR at W48) were included. Median baseline BA levels were significantly higher in patients with ACLD and portal hypertension (n = 10; 19.2 vs. 5.1 μmol/L; p = 0.015). No difference in median on-treatment BA levels was detected between patients achieving VR or VNR at W24 (VR: 25.4 vs. VNR: 22.7 μmol/L; p = 1.000) and W48 (VR: 25.4 vs. VNR: 20.8 μmol/L; p = 1.000). Additionally, ΔBA from baseline to W48 did not differ between VR and VNR (p = 0.534). No significant association between ΔBA and HDV-RNA dynamics at W48 was detected. After BLV discontinuation, median BA levels significantly dropped to normal ranges (18.9 μmol/L at last on-BLV assessment to 7.6 μmol/L after discontinuation; p = 0.028). On-treatment BA levels did neither associate with self-reported compliance nor with treatment-related adverse events.

conclusionBulevirtide increases bile acid levels in most patients, but ΔBA does not predict virologic response or adverse events, nor does it reflect compliance to therapy. Bile acid level monitoring during and following bulevirtide treatment is thus, not advised for clinical practise.

Indexed as

Antiviral AgentsBile Acids and SaltsHepatitis DLipopeptidesAdultFemaleHepatitis Delta VirusHumansMaleMiddle AgedRNA, ViralSeverity of Illness IndexTreatment OutcomeAntiviral AgentsBile Acids and SaltsbulevirtideLipopeptidesRNA, Viralbile acidsbulevirtidechronic hepatitis Dvirologic response

Identifiers

PMID42012135
PMCPMC13309211

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.