Upon joining the study, participants will be required to sign a written informed consent form. This form confirms understanding of the study and agreement to participate.

Participants must be at least 18 years old and have been diagnosed with chronic hepatitis D infection for at least six months prior to joining the study.

An initial assessment will be conducted to evaluate the participant’s health status. This includes checking for conditions such as ascites (fluid in the abdomen) and hepatic encephalopathy (a decline in brain function due to liver disease).

Laboratory tests will be performed to measure levels of serum bilirubin, serum creatinine, international normalized ratio (INR), and serum albumin. These tests help calculate scores that assess liver function.

Participants will begin treatment with bulevirtide, administered as a solution for injection under the skin (subcutaneous use).

The dosage is 2 mg of bulevirtide, and the frequency and duration of administration will be determined according to the approved treatment plan.

Participants will attend regular visits to monitor their health and the effects of the treatment. This includes checking for any liver-related events such as hepatic decompensation, hepatocellular carcinoma, or other serious conditions.

The study will track the percentage of participants who develop cirrhosis and any serious adverse events that occur during the treatment period.

The study is expected to continue until September 30, 2027. Participants will be involved in the study for up to 144 weeks, depending on their individual treatment plan.

At the end of the study, a final assessment will be conducted to evaluate the long-term effects of bulevirtide treatment on liver disease progression.