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**Bulevirtide + tenofovir** is a **combination therapy** used in the treatment of chronic hepatitis D virus (HDV) infection, specifically in patients who are also chronically infected with hepatitis B virus (HBV)[1][5]. Bulevirtide is a first-in-class peptidic entry inhibitor derived from the preS1 domain of the HBV L-surface protein; it binds to and inhibits the sodium taurocholate cotransporting polypeptide (NTCP) receptor on hepatocyte surfaces, blocking HDV and HBV entry into liver cells[2][6][7]. Tenofovir is a nucleotide analogue reverse transcriptase inhibitor, which, once activated, inhibits viral polymerase and causes chain termination, thereby preventing viral replication[4]. The combination is typically administered as **subcutaneous bulevirtide** and **oral tenofovir disoproxil fumarate (TDF)**. The primary clinical indication is chronic hepatitis D infection in the context of HBV coinfection, especially in patients with compensated liver disease[5]. Efficacy has been demonstrated in randomized trials, showing significant reductions in HDV RNA with the combination versus monotherapy[1][5].
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