Evidence mapPaperPMID 41108575Full record

ArticleLiver international : official journal of the International Association for the Study of the Liver2025

Impact of Handling Perception and Language Barriers on Virologic Response to Daily Subcutaneous Bulevirtide in Hepatitis D.

Toni Herta, Christopher Dietz-Fricke, Münevver Demir, Kathrin Sprinzl, Kai-Henrik Pfeiffer, Julia M Grottenthaler, Peter Buggisch, Wolfgang Maximilian Kremer, Florian P Reiter, Andreas Geier and 8 more

Abstract readMulticenter Study
In one paragraph

Article in Liver international : official journal of the International Association for the Study of the Liver, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. 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 · 2026
    Review
  2. Observational
  3. Impact of Handling Perception and Language Barriers on Virologic Response to Daily Subcutaneous Bulevirtide in Hepatitis D.Liver international : official journal of the International Association for the Study of the Liver · 2025
    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

18 authors.

Toni HertaDepartment of Hepatology and Gastroenterology, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Charité - Universitätsmedizin Berlin, Berlin, Germany.ORCID 0000-0002-0401-1140
Christopher Dietz-FrickeDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.
Münevver DemirDepartment of Hepatology and Gastroenterology, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Charité - Universitätsmedizin Berlin, Berlin, Germany.
Kathrin SprinzlGoethe University Frankfurt, University Hospital, Germany.
Kai-Henrik PfeifferDepartment of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
Julia M GrottenthalerDepartment of Gastroenterology, Gastrointestinal Oncology, Hepatology, Infectiology, and Geriatrics, University Hospital Tuebingen, Tuebingen, Germany.ORCID 0000-0001-9122-0962
Peter BuggischIfi-Institute for Interdisciplinary Medicine, Hamburg, Germany.
Wolfgang Maximilian KremerDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Florian P ReiterUniversity Hospital Würzburg, Division of Hepatology, Dept. of Medicine II, Würzburg, Germany.
Andreas GeierUniversity Hospital Würzburg, Division of Hepatology, Dept. of Medicine II, Würzburg, Germany.
Christoph SchrammDepartment of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany.ORCID 0000-0001-6752-0690
Uta MerleDepartment of Internal Medicine IV, University of Heidelberg, Heidelberg, Germany.
Christoph Neumann-HaefelinDepartment of Medicine II, University Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Frank TackeDepartment of Hepatology and Gastroenterology, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Charité - Universitätsmedizin Berlin, Berlin, Germany.ORCID 0000-0001-6206-0226
Thomas BergDivision of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.
Heiner WedemeyerDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.ORCID 0000-0003-2906-0480
Katja DeterdingDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.
Johannes WiegandDivision of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.ORCID 0000-0001-9233-4064

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBulevirtide (BLV) is the only approved therapy for chronic hepatitis D (CHD) and compensated liver disease. Daily subcutaneous injection and the need for refrigeration may pose challenges, especially in patients with limited language proficiency.

aimsAssessment of patient-reported BLV handling and satisfaction and association with virologic response.

methodsPatients receiving BLV were assessed using a structured questionnaire on injection preparation, administration, refrigeration, adverse effects, and language proficiency. Virologic response was defined as complete (≥ 2 log10 reduction from baseline or HDV RNA undetectable), intermediate (≥ 1 log10 but < 2 log10 reduction), non-response (< 1 log10 reduction or increase), or breakthrough (> 1 log10 increase after ≥ 2 log10 reduction).

resultsA total of 115 patients from 30 countries were recruited at 12 German centres. German language skills were rated as good, sufficient, poor or absent in 58%, 25% and 17% of cases. Reported difficulties included injection preparation (17%), administration (25%) and refrigeration (27%). Patients without virologic response or with viral breakthrough reported difficulties with injection administration in 56% compared to 17% with intermediate or complete response (p = 0.0002), while no differences were observed regarding preparation or refrigeration. Injection site reactions occurred in 57% of patients. Overall, 82% were satisfied with the practical handling and 94% with the tolerability of BLV. Good language proficiency was associated with greater satisfaction with the practical handling (p = 0.0067), which in turn correlated with virologic response (p = 0.0001).

conclusionsBLV administration is generally well manageable. Limited language proficiency and injection difficulties may negatively affect patient satisfaction and potentially influence treatment outcomes.

trial registrationGerman Clinical Trials Registry (DRKS 00033153).

Indexed as

Antiviral AgentsCommunication BarriersLanguagePeptide FragmentsAdultAgedFemaleGermanyHepatitis Delta VirusHumansInjections, SubcutaneousMaleMiddle AgedPatient SatisfactionSurveys and QuestionnairesAntiviral AgentsPeptide FragmentsBLVpatient‐reported outcomespegylated interferon alfa‐2aself‐injectionvirologic response

Identifiers

PMID41108575
PMCPMC12535276

What Socratic holds

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Registered trials

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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 Socratic graph.