Resolution of Hepatitis Delta Virus-Related Cryoglobulinemic Vasculitis With the Use of Bulevirtide

Abstract The global prevalence of hepatitis B virus (HBV) infection is around 257 million people, and about 5% are coinfected with hepatitis delta virus (HDV). HDV infection can progress from acute fulminant hepatitis to chronic hepatitis, cirrhosis, or hepatocellular carcinoma. About 20% of HBV patients develop extrahepatic manifestations; among them, cryoglobulinemic vasculitis (CV) occurs in less than 5% of cases and can lead to heterogeneous clinical manifestations. We present the case of a woman with HBV-HDV coinfection who was referred to our clinic with suspected virus-related CV. One-year treatment with bulevirtide led to complete and durable resolution of CV.