Upon joining the study, an initial assessment is conducted to confirm eligibility. This includes checking age, health status, and current treatment with bulevirtide for at least 24 weeks.

Blood tests are performed to measure HDV RNA levels, which should be at least 500 IU/mL. Liver health is assessed to ensure noncirrhotic or compensated cirrhotic liver disease.

The treatment involves a combination of tobevibart and elebsiran, administered through subcutaneous injections. This means the medication is injected under the skin.

The specific dosage and frequency of these medications are determined by the study protocol and are explained during this phase.

Regular visits are scheduled to monitor health and the effectiveness of the treatment. Blood tests are conducted to measure changes in HDV RNA and liver function.

Participants are observed for any side effects or adverse events. Adjustments to the treatment plan may be made based on these observations.

At week 24, a comprehensive evaluation is conducted to assess the reduction in HDV RNA levels. The goal is to achieve levels below the limit of detection.

Liver function tests and other health assessments are performed to ensure the treatment is working effectively.

Participants continue to receive treatment and are monitored at regular intervals, including weeks 48 and 96, to track long-term effects and health outcomes.

The study aims to observe the sustained response and any potential long-term benefits or risks associated with the treatment.

In the later stages, treatment may be systematically interrupted to evaluate the body’s response without medication. This occurs around week 96.

Final evaluations are conducted up to week 240 to assess the long-term impact of the treatment and any changes in health status.