Hepatitis Delta Coinfection
The Hepatitis B Foundation interviewed Dr. Coffin about Hepatitis Delta Coinfection -- the challenges and the opportunities ahead.
HOW IS HEPATITIS DELTA TREATED?
In this video, Helenie Kefalakes, specialist in internal medicine at the Department for Gastroenterology, Hepatology, Infectiology and Endocrinology at the Hannover Medical School in Germany, answers the following questions in her lecture “Standard of treatment in Germany and worldwide”
• How should hepatitis D virus infection be treated?
• How can patients with advanced liver disease be treated?
• When is a liver transplant an option?
Update on CDA's recommendation for Hepcludex
Last year, Canadian Hepatitis B Network members provided clinician input on Gilead’s submission of Hepcludex (bulevirtide) to the Canadian Drug Agency (CDA), and then subsequently submitted a response letter to the initial review. Both letters are posted below.
As of January 2026, the CDA has updated their recommendation (Bulevirtide (Hepcludex)), and below we highlight key elements that were / were not adopted.
Key elements where CanHepB input was reflected in the final recommendation:
1) Platelet threshold removed at initiation: CDA removed the draft platelet count requirement, acknowledging expert feedback that thrombocytopenia is not a reliable proxy for decompensation and that this criterion excluded patients similar to those enrolled in MYR301.
2) ALT normalization no longer required for renewal: The draft requirement for ALT normalization at 48 weeks was relaxed. In the final recommendation, renewal may proceed based on virologic response (undetectable HDV RNA or ≥2 log₁₀ decline), with ALT monitoring left to specialist judgment rather than mandated normalization.
Elements raised by CanHepB that were not fully adopted:
Decompensated disease and HCC: Despite CanHepB’s recommendation to allow continued treatment in selected patients with decompensated liver disease or HCC based on specialist judgment, the final recommendation maintains exclusion of these populations from routine reimbursement, with re-initiation left to clinical discretion in the event of relapse.