Journal Of Viral Hepatitis[JOURNAL]
Sun
200 papers
Exploration of a Model for Elimination of Hepatitis C in Women of Childbearing Age in Primary Hospitals in Southern China.
Guo L, Wu W, Zhou W … +9 more , Liang R, Lin Y, Chen Y, Wu Y, Fei J, Chen Y, Ruan L, Zeng H, Gao B
J Viral Hepat · 2026 Apr · PMID 41857482 · Publisher ↗
Hepatitis C virus (HCV) can be transmitted from mother to child, although data on HCV elimination in women of childbearing age remain limited. This study aimed to evaluate an intervention model aligning with the 'treatme...
Hepatitis C virus (HCV) can be transmitted from mother to child, although data on HCV elimination in women of childbearing age remain limited. This study aimed to evaluate an intervention model aligning with the 'treatment as prevention' strategy. The 'Hepatitis C Prevention and Treatment Project for Women of Childbearing Age (15-49 years)', launched in October 2022, strengthened the use of HCV-Ab screening, RNA testing, and treatment referral through multidisciplinary hospital collaborations. Key indicators (screening, RNA testing, and treatment rates) were compared between the pre-intervention (October 2021-September 2022) and post-intervention (October 2022-September 2023) periods. Additionally, a retrospective analysis of 503 HCV-Ab-positive women diagnosed between 2015 and 2024 was performed, together with a recall of the patients for RNA testing and treatment. The post-intervention rates for screening rose from 41.5% to 66.2%, while those for RNA testing increased from 45.9% to 97.9%, and treatment from 52.6% to 97.3% (all p < 0.001). Among the 503 historical cases, 337 (67.0%) returned for follow-up, with 92.5% completing RNA testing (312/337), 65.1% found to be RNA-positive (203/312) and 91.3% began treatment (185/203). Of these, 98.9% (183/185) achieved SVR12 after direct-acting antiviral therapy. Another 124 (24.7%) agreed to future testing. These findings demonstrated that targeted interventions significantly improve the rates of HCV diagnosis and treatment in women of childbearing age, enabling early detection and reducing the risk of transmission. This model offered a practical approach to eliminating HCV in this population, fulfilling the 'treatment as prevention' goal.
Characteristics of Patients and Factors Associated With the Development of Hepatitis C Virus-Associated Hepatocellular Carcinoma in an Urban, Primary-Care Based Hepatitis C Clinic.
Thompson K, Thompson J, Miller LS
J Viral Hepat · 2026 Apr · PMID 41846468 · Publisher ↗
Chronic hepatitis C virus infection (HCV) is one of the leading causes of hepatocellular carcinoma (HCC) in the United States. Using a retrospective cross-sectional analysis, this study identified patient characteristics...
Chronic hepatitis C virus infection (HCV) is one of the leading causes of hepatocellular carcinoma (HCC) in the United States. Using a retrospective cross-sectional analysis, this study identified patient characteristics and factors associated with the development of HCV-associated HCC in 113 patients seen in the primary care-based HCV clinic in Grady Memorial Hospital, a public, safety-net healthcare facility in Atlanta, Georgia from October 2013 to November 2024. The study population was comprised of mostly African American men with high rates of polysubstance use, 96.5% of whom had cirrhosis. Patients treated for HCV prior to HCC diagnosis were older at HCC diagnosis (mean difference 3.248, p-value 0.037), had a longer latency period between HCV and HCC diagnoses (mean difference 38.740, p-value 0.002), had prior HCC screening (mean difference 0.547, p-value 0.000), and less time from last HCC screening to HCC diagnosis (mean difference -25.332, p-value 0.012), and had a lower Child-Pugh Score at time of HCC diagnosis (mean difference -0.300, p-value 0.036) compared to patients who were not treated for HCV. For patients who achieved SVR prior to HCC, HCV genotype 1 was associated with longer time to HCC diagnosis (p-value 0.030), and a higher FIB-4 index at the time of achieving SVR and longer knowledge of HCV infection were associated with shorter time to developing HCC (p-value 0.003; p-value 0.044). Ultimately, this study highlights the importance of understanding risk factors for HCV-associated HCC in underserved populations which could help providers tailor their approach to mitigate the risk of HCC.
Methodological Considerations in Prevalence Meta-Analysis of Hepatitis B Among Migrants.
Thakur HS, Yadav V
J Viral Hepat · 2026 Apr · PMID 41846411 · Publisher ↗
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Co-Administration of Hepatitis C Direct-Acting Antivirals and Enzyme-Inducing Antiepileptic Drugs: Real-World Experience From a Multi-Centre Case Series.
Harrison R, Patel S, Marra F … +7 more , Francisco A, Boothman H, Kim Y, Kamiri-Ngugi R, Lacey J, Henry J, Boyle A
J Viral Hepat · 2026 Apr · PMID 41841423 · Publisher ↗
The management of hepatitis C virus (HCV) infection in patients requiring ongoing enzyme-inducing antiepileptic drugs (eiAEDs) presents a therapeutic challenge due to potential drug-drug interactions with direct-acting a...
The management of hepatitis C virus (HCV) infection in patients requiring ongoing enzyme-inducing antiepileptic drugs (eiAEDs) presents a therapeutic challenge due to potential drug-drug interactions with direct-acting antivirals (DAAs). Evidence regarding DAA treatment efficacy in this context remains limited. This case series examined the outcomes of patients with HCV who continued their eiAED therapy while being treated with conventional regimens of DAAs. A total of 23 patients with HCV were treated with standard doses and durations of HCV DAAs in combination with eiAEDs. High treatment adherence was reported for 19 (82.6%) patients and 21 (91.3%) achieved sustained virological response; two were lost to follow-up. Despite potential for reduced DAA levels, no virological failures or serious adverse events were observed in patients attending follow-up. This represents the largest reported single case series involving concomitant use of eiAEDs and DAAs. The findings provide reassurance that standard-dose DAA treatment can be effective even when co-administered with eiAEDs.
Changing Pattern of HDV Infection in Italy Over 40 Years; the Current Scenario and the Impending Challenge.
Caviglia GP, Stroffolini T
J Viral Hepat · 2026 Apr · PMID 41841404 · Full text
Since the initial description of HDV, in the last four decades Italy has witnessed a profound decline of the infection driven by HBV vaccination, contrasted however by the reconstitution of a viral reservoir through migr...
Since the initial description of HDV, in the last four decades Italy has witnessed a profound decline of the infection driven by HBV vaccination, contrasted however by the reconstitution of a viral reservoir through migratory flows from endemic HDV areas; in parallel, the medical scenario has changed, resulting in different clinical outcomes. The epidemiological and clinical changes were documented by national surveys performed up to 2025, which provided an ongoing perspective on the long-term evolution of HDV, highlighting the temporal trends in prevalence, risk factors, and clinical features. This review summarises the changes over time of HDV in Italy and the contemporary epidemiologic features of an infection that is vanishing among natives but increasing among migrants, outlining the medical challenge of a new heterogeneous clinical spectrum, including indolent phenotypes.
HBV RNA Predicts the Risk of Off-Treatment Relapse in Chronic Hepatitis B Patients With NAs Therapy: A Systematic Review and Meta-Analysis.
Wang DH, Wang JL, Jiang SW … +6 more , Zhou AW, Jin MH, Zhang HJ, Yang SQ, Fan SY, Hu AR
J Viral Hepat · 2026 Apr · PMID 41830105 · Full text
Since there are currently few antiviral drugs that can effectively reduce hepatitis B surface antigen levels, the recurrence rate remains high in patients with chronic hepatitis B (CHB) after discontinuing nucleoside ana...
Since there are currently few antiviral drugs that can effectively reduce hepatitis B surface antigen levels, the recurrence rate remains high in patients with chronic hepatitis B (CHB) after discontinuing nucleoside analogues (NAs) treatment. This study aims to provide recommendations for monitoring relapse after treatment cessation, while also elucidating the significance of HBV RNA in predicting relapse in CHB patients. Studies published between 2019 and 2025 were searched using PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and Cqvip. There are 21 cohort studies included and 2043 individuals involved. In our study, HBV RNA-positive individuals had a 1.9-fold higher viral relapse (VR) rate and a 2.26-fold higher clinical relapse (CR) rate compared to negative patients (all p < 0.0001). Subgroup analyses indicated that HBeAg positive at baseline was associated with higher rates of CR (p = 0.006) and no significant correlation between longer follow-up period following the cessation of NAs therapy (≥ 2 years) and higher VR or CR. For each log10 copies/ml increase in HBV RNA levels at discontinuation, there was a 1.32-fold increase in VR and a 1.37-fold increase in CR (all p < 0.0001). Our findings evaluated the relationship between HBV RNA status and levels at the time of NAs discontinuation and post-discontinuation relapse, highlighting HBV RNA as a helpful post-treatment biomarker for predicting relapse. HBV RNA surveillance is essential for patients discontinuing therapy following NAs, particularly for those who are HBeAg-positive at baseline.
Delivering Effective Hepatitis C Virus Treatment in an Embedded Primary Care Setting Within a Tertiary Care Hospital in Karachi, Pakistan.
Shah S, Mafirakureva N, Trickey A … +9 more , Hasnain A, Khan U, Khowaja S, Ashraf H, Baig-Ansari N, Hickman M, Vickerman P, Walker JG, Lim AG
J Viral Hepat · 2026 Apr · PMID 41816953 · Full text
Hepatitis C virus (HCV) endemic regions require accessible treatment interventions. Effectiveness and costs of a pilot HCV treatment programme were evaluated at an embedded primary care service within a tertiary care cen...
Hepatitis C virus (HCV) endemic regions require accessible treatment interventions. Effectiveness and costs of a pilot HCV treatment programme were evaluated at an embedded primary care service within a tertiary care centre at Indus Hospital and Health Network in Karachi, Pakistan. Data on patients (n = 1288, median age 40 years) initiating direct-acting antiviral (DAA) treatment (October 2016 to December 2018) were extracted from hospital records. Eligible patients had chronic HCV, were treatment naïve, and without hepatic decompensation. Multivariable logistic regression analysed factors associated with treatment outcomes (not completing treatment, treatment completion without sustained virological response test at 12 weeks (SVR12) visit, and treatment completion with SVR12). Costs (2019 USD) were estimated using micro-costing from financial records and staff interviews. Among 1288 patients (63% women), 93% (1200/1288) completed treatment, and 74% (884/1200) attended SVR12 visit, with 98% (n = 870/884) cured. Compared with 0-29 year-olds, incomplete treatment was lower among 30-49 year-olds (aOR 0.47 [0.26-0.83]) and ≥ 50 year-olds (aOR 0.48 [0.24-0.93]). SVR12 non-attendance was higher for 24-week versus 12-week regimens (aOR: 3.46 [1.51-7.93]), but lower for patients with APRI scores 0.5-1.49 (aOR 0.69 [0.50-0.96]) and ≥ 1.5 (aOR 0.44 [0.24-0.78]) compared to 0-0.49. The mean treatment cost was $370.74 per patient, driven by clinic visits $271.80 (73.3%), labs $68.32 (18.4%), and DAAs $30.62 (8.3%). Overall, a high treatment completion and cure rate were achieved, with a low average cost per patient, indicating that this HCV treatment model can be affordable and may be considered for widescale treatment scale-up in Pakistan.
Hepatitis B Vaccine Response in Children of Vaccinated Versus Unvaccinated Mothers: A Retrospective Cohort Study.
Shibli S, Suki M, Korzom T … +2 more , Green MS, Safadi R
J Viral Hepat · 2026 Apr · PMID 41804915 · Full text
Universal infant hepatitis B (HBV) vaccination is highly effective in preventing infection. However, little is known about whether a mother's HBV vaccination history influences her child's immune response to routine immu...
Universal infant hepatitis B (HBV) vaccination is highly effective in preventing infection. However, little is known about whether a mother's HBV vaccination history influences her child's immune response to routine immunisation. We aimed to compare vaccine-induced antibody responses in children of vaccinated and unvaccinated mothers. We conducted a historical-retrospective cohort study of 364 children who completed the standard infant HBV vaccination series and underwent post-vaccination antibody testing. Maternal vaccination status was determined by serology, medical records and cohort year. Children were classified as offspring of HBsAg-negative vaccinated mothers (n = 92), HBsAg-negative unvaccinated mothers (n = 174), or HBsAg-positive mothers (n = 98), who also received hepatitis B immunoglobulin (HBIG) at birth. Anti-HBs titers were analysed and categorised. Ordinal logistic regression was used to assess associations. Overall seroprotection rates (≥ 10 mIU/mL) were high (89.3%) and did not differ significantly between groups. However, children born to mothers vaccinated prior to pregnancy were significantly more likely to achieve very high antibody levels (≥ 1000 mIU/mL) compared with children of unvaccinated mothers or those who received HBIG at birth (p < 0.05). This association was most pronounced in children tested at ≤ 3 years of age. Mean anti-HBs titers were also highest in offspring of vaccinated mothers. While older maternal age and lower haemoglobin levels impaired the response, the HBIG did nothing. While infant HBV seroprotection rates were uniformly high regardless of maternal background, children born to mothers vaccinated against HBV prior to pregnancy exhibited a more robust early antibody response (≥ 1000 mIU/mL). These findings suggest a possible intergenerational enhancement of vaccine responsiveness and may affect long-term implications for HBV vaccination strategies.
A New Model for Hepatitis C Elimination: CDC-Dispatching Follow-Up Coordinators Stationed in Hospitals.
Xu J, Cao Y, Xiao Y … +3 more , Li W, He M, Li Y
J Viral Hepat · 2026 Apr · PMID 41804234 · Publisher ↗
This study aimed to establish and evaluate a three-tiered closed-loop management model for hepatitis C involving 'CDC-community-follow-up coordinators', so as to improve the referral rate and DAA treatment rate for previ...
This study aimed to establish and evaluate a three-tiered closed-loop management model for hepatitis C involving 'CDC-community-follow-up coordinators', so as to improve the referral rate and DAA treatment rate for previously diagnosed but untreated (DBU) patients, enhance the diagnosis and treatment coverage for in-hospital HCV antibody-positive patients, and accelerate the elimination of hepatitis C. In April 2024, the novel 'CDC-community-stationed follow-up coordinators' model for hepatitis C management was launched in Nanhai District, Foshan City, with the CDC coordinating the recall of historical DBU patients; through government-procured third-party follow-up services, stationed follow-up coordinators were assigned to Nanhai District People's Hospital to facilitate the follow-up, diagnosis and treatment of both in-hospital patients and external DBU patients, while comparisons were conducted between pre- and post-implementation periods regarding HCV RNA testing rates, DAA treatment rates and diagnosis-to-treatment delays, and treatment adherence and completion rates across different populations were assessed. A total of 4975 DBU patients between 2004 and 2024 were identified from the CDC database, and after 3 months of telephone follow-up, the response rate was 38.21% (1901/4975), the recall rate 23.55% (401/1703), the HCV RNA positivity rate 25.69% (103/401), and the DAA treatment rate 54.4% (56/103). After the implementation of the model, the in-hospital HCV RNA testing rate for anti-HCV-positive patients increased from 68.1% (738/1084, January 2022-March 2024) to 90.97% (393/432, April-December 2024), and the DAA treatment rate rose from 43.1% (116/269, January 2022-March 2024) to 76.7% (92/120, April-December 2024); the mean time from antibody positivity to RNA testing decreased from 19.3 days to 11.0 days, and the time from diagnosis to treatment initiation shortened from 42.2 days to 22.6 days. The CDC-dispatching stationed follow-up coordinator model enables effective link-to-care for DBU patients and significantly improves the diagnosis and treatment rates of in-hospital HCV cases, demonstrating strong potential for scaling up in resource-limited settings.
Prolonged Intrahepatic Cholestasis After Acute Hepatitis E Infection: A Case Series and Genetic Analysis.
Fraga M, Kasmi S, Weber SN … +9 more , Liebe R, Sempoux C, Saadat A, Fellay J, Kenngott-Kelber S, Zimmer V, Lammert F, Krawczyk M, Jüngst C
J Viral Hepat · 2026 Apr · PMID 41797682 · Full text
Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis worldwide. Whereas HEV infection is typically self-limiting, rare cases of prolonged cholestasis have been reported. The underlying mechanisms remain un...
Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis worldwide. Whereas HEV infection is typically self-limiting, rare cases of prolonged cholestasis have been reported. The underlying mechanisms remain unclear, though host genetic variation may contribute. This study aimed to investigate the role of genetic predisposition in HEV-induced prolonged cholestasis by analysing variants in genes associated with hepatocanalicular transport. We performed a retrospective review of medical records from three university centres in Switzerland and Germany and identified five immunocompetent patients with prolonged cholestasis following acute HEV infections. Genetic analysis using next-generation sequencing included a panel of five genes involved in cholestatic liver diseases (ATP8B1, ABCB11, ABCB4, ABCC2 and MYO5B). Variant frequencies were evaluated using population reference databases and compared with a genetically characterised cohort of asymptomatic HEV-infected blood donors. All five patients were male, with a median age of 59 years. The median duration of cholestasis exceeded 77 days. Two patients exhibited potentially pathogenic heterozygous variants: ATP8B1 p.N45T in one patient and MYO5B p.K429R in another. Additionally, common ABCB11 variants were detected in all patients, which might have contributed to cholestatic clinical presentation. In the asymptomatic HEV-infected controls, the MYO5B p.K429R variant was absent, whereas the ATP8B1 p.N45T variant was detected in only one individual in a heterozygous state. These case series illustrate that host genetics might influence the severity of HEV infection, particularly prolonged cholestatic jaundice. Further research is needed to explore the interaction between viral infections and host genetics in liver disorders.
The Impact of Ambient Temperature on HCC Risk in Patients With Chronic Hepatitis B.
Jang TY
J Viral Hepat · 2026 Apr · PMID 41787600 · Publisher ↗
Abstract loading — click title to view on PubMed.
Prevalence of Active HCV Infection in Spain in 2022 Using Multiparameter Evidence Synthesis.
Thomadakis C, Gountas I, Gountas K … +25 more , Nuño N, Brime B, Sendino R, Albillos A, Buti M, Crespo J, Berenguer J, Alonso S, de Santiago AD, Hernando V, Laguno M, Lens S, Diago M, Montes ML, García-Samaniego J, Morano L, Moreno JL, Navarro J, Romero-Gómez M, Santos L, Soriano R, Duffell E, Diaz A, Del Amo J, Nikolopoulos G
J Viral Hepat · 2026 Apr · PMID 41772819 · Full text
Hepatitis C virus (HCV) remains a major public health concern worldwide. Spain has implemented large-scale direct-acting antiviral (DAA) treatment programs, yet the prevalence of active HCV infection (aHCV) and its trend...
Hepatitis C virus (HCV) remains a major public health concern worldwide. Spain has implemented large-scale direct-acting antiviral (DAA) treatment programs, yet the prevalence of active HCV infection (aHCV) and its trends over time remain incompletely characterised. We applied Bayesian multiparameter evidence synthesis (MPES) to estimate the prevalence of aHCV in Spain in 2022 and its change from 2019 to 2022. The Spanish population aged 15-79 years was stratified into four non-overlapping risk groups: current people who inject drugs (PWID), ex-PWID, gay-bisexual and other men who have sex with men (GBMSM) engaging in chemsex (GBMSMchem), and the general population. Data sources included, among others, national seroprevalence surveys, behavioural studies, national databases, and clinical records on DAA treatment outcomes. The estimated overall aHCV prevalence in Spain in 2022 was 0.14% (95% Credible Interval: 0.05%-0.27%), corresponding to approximately 54,500 individuals. Prevalence was highest among current PWID (12.5%) and GBMSMchem (8.4%). Compared to 2019, the total number of aHCV cases declined by ~20,000, largely attributable to DAA treatment. Among the general population, 29.4% of aHCV cases remained undiagnosed, with the highest prevalence in individuals aged 50-59 (0.25%) and 60-69 (0.16%) years. Spain has made substantial progress towards HCV elimination, but key populations such as PWID and GBMSMchem remain at high risk. Targeted interventions, including expanded harm reduction services and accessible HCV testing and treatment, are essential to achieving the World Health Organization (WHO) elimination targets by 2030.
Prevalence and Factors Associated With Hepatitis C in Danish Prisons, 2022-2024: A Multicentre Cross-Sectional Study.
Demant J, Søholm J, Lazarus JV … +8 more , Krohn-Dehli L, Egelund C, Madsen S, Barfod T, Kremer C, Nilsson SS, Skovdal DA, Weis N
J Viral Hepat · 2026 Apr · PMID 41772784 · Full text
Prisons offer a critical opportunity for hepatitis C virus (HCV) elimination, yet current data from Danish correctional facilities are sparse. We conducted a cross-sectional study in 16 prisons across Eastern Denmark bet...
Prisons offer a critical opportunity for hepatitis C virus (HCV) elimination, yet current data from Danish correctional facilities are sparse. We conducted a cross-sectional study in 16 prisons across Eastern Denmark between October 2022 and August 2024, enrolling 651 incarcerated individuals. All participants underwent HCV antibody and RNA testing using dried blood spots and completed a bio-behavioural risk survey. The prevalence of HCV antibody and HCV RNA was 4.2% (n = 26) and 2.0% (n = 13) respectively. HCV exposure was most prevalent among individuals with a history of injecting drug use (56.4%), women (11.3%) and foreign-born individuals (6.7%). In multivariable logistic regression, HCV exposure was significantly associated with injecting drug use (adjusted odds ratio [aOR] 209.11, 95% confidence interval [CI]: 36.16-1209.27), female sex (male vs. female: aOR 0.18, 95% CI: 0.05-0.60) and being born in a low-prevalence country (aOR 6.22, 95% CI: 1.64-23.61). We observed substantial site-level variation and care gaps that disproportionately affect marginalised groups. These findings support the implementation of targeted HCV screening at prison intake, along with facility-specific and population-tailored interventions, as essential strategies for achieving Denmark's commitment to the World Health Organization's HCV elimination goal.
The Impact of Hepatitis C and Socio-Demographic Variables on Health-Related Quality of Life in Pakistan: Cross-Sectional Study.
Niyomsri S, Lim AG, Arif A … +14 more , Asim M, Chaudhry A, Choudhry N, Hasnain A, Kemos P, Metcalfe C, Choudhry A, Hamid SS, Niaz S, Qureshi H, Foster GR, Vickerman P, Walker JG, HepFreePak team
J Viral Hepat · 2026 Apr · PMID 41761835 · Full text
Approximately 8.8 million people are living with chronic hepatitis C virus (HCV) in Pakistan. We assessed factors related to health-related quality of life (HRQoL) among the general population screened for HCV and calcul...
Approximately 8.8 million people are living with chronic hepatitis C virus (HCV) in Pakistan. We assessed factors related to health-related quality of life (HRQoL) among the general population screened for HCV and calculated the national burden in quality-adjusted life years (QALYs). A cross-sectional study was conducted in community and clinic-based settings in Karachi and Gujranwala. HRQoL was assessed before diagnosis using EQ-5D-3L (Pakistan value set). Propensity score matching (PSM) was used to address socio-economic differences between HCV RNA-positive (viraemic) and HCV-antibody-negative participants. We assessed socio-demographic and HCV-related predictors of HRQoL (Tobit regression) and problems by EQ-5D domain (logistic regression). The HCV transmission model was used to estimate the burden of HCV in terms of morbidity- and mortality-related QALY loss in 2024. After PSM, 778 individuals remained in each group from a total of 5468 participants. HCV-positive participants had lower HRQoL (EQ-5D-3L score, p < 0.001) and higher odds of problems in all five EQ-5D dimensions. Lower HRQoL was associated with older age and unemployment, while married or Urdu-speaking participants had higher HRQoL. There was little evidence that cirrhosis was associated with HRQoL (p = 0.140) among HCV-positive participants. The total estimated QALY loss due to HCV in Pakistan in 2024 was 804,580 QALYs, of which 55% was due to mortality. HCV infection is associated with reduced HRQoL and substantial QALY losses in Pakistan. Our findings emphasise the role of socio-demographic variables on HRQoL. Further research in Pakistan is needed to determine if HCV treatment can mitigate these effects.
Prevalence, Clinical Presentation and Outcome of Hepatitis B Patients With Indeterminate Phase: A Systematic Review and Meta-Analysis.
Li J, Xu X, Liu J … +13 more , Li M, Issa R, Bai X, Kam LY, Stave CD, Ni W, Rui F, Zhu Y, Ma X, Gu Q, Pan Y, Wu C, Nguyen MH
J Viral Hepat · 2026 Apr · PMID 41761832 · Publisher ↗
Although current guidelines classify the natural history of chronic hepatitis B (CHB) into several immune phases, a substantial proportion of patients with CHB do not meet criteria for any of the defined immune phases an...
Although current guidelines classify the natural history of chronic hepatitis B (CHB) into several immune phases, a substantial proportion of patients with CHB do not meet criteria for any of the defined immune phases and are considered to be in an indeterminate phase. We aim to perform a meta-analysis to systematically evaluate the prevalence, clinical presentation and outcome of indeterminate CHB patients classified according to American Association for the Study of Liver Diseases (AASLD) 2018 guidelines or European Association for the Study of the Liver (EASL) 2017 guidelines. We searched four databases from inception to Aug 21, 2024, for studies reporting the prevalence, characteristics and/or clinical outcomes of patients with indeterminate CHB classified according to AASLD 2018 guidelines or EASL 2017 guidelines. Of the 4553 studies initially identified, 50 studies met study inclusion criteria and were analysed. The prevalence of indeterminate patients was 38.90% (95% CI: 33.51-44.57) and 38.81% (95% CI: 31.22-46.99) by AASLD 2018 and EASL 2017 guidelines, respectively. Among indeterminate CHB patients, the pooled incidence rate per 1000 person-years for hepatocellular carcinoma and liver-related events was 5.36 (95% CI: 1.38-9.35) and 7.27 (95% CI: 0.00-22.21) per AASLD 2018 guidelines and 5.20 (95% CI: 1.41-8.99) and 9.79 (95% CI: 0.00-25.35) per EASL 2017 guidelines, respectively. Indeterminate phase affects nearly 40% of CHB patients who are at risk for hepatocellular carcinoma and liver-related adverse outcomes. Further research is needed to inform treatment strategies specifically tailored for the indeterminate CHB patients.
Enhancing Chronic Hepatitis B and D Management Through a Tailored Mobile Health Application: Real-World Outcomes From the Adaptation of the NORA App.
Romero-Vico J, Feliu A, Vargas-Accarino E … +7 more , Sánchez-Gavilán E, Ribó M, Palom A, Ruiz-Cobo JC, Riveiro M, Fabrellas N, Buti M
J Viral Hepat · 2026 Apr · PMID 41731678 · Publisher ↗
Chronic hepatitis B (CHB) and hepatitis D (CHD) remain global health challenges, where sustained care engagement, treatment adherence and regular monitoring are essential but often limited by stigma and healthcare access...
Chronic hepatitis B (CHB) and hepatitis D (CHD) remain global health challenges, where sustained care engagement, treatment adherence and regular monitoring are essential but often limited by stigma and healthcare access. Digital health tools offer new opportunities to bridge these gaps. This study aimed to adapt the NORA mobile health app for CHB and CHD patients and evaluate its real-world utility in improving knowledge, adherence, communication and quality of life. We conducted a prospective, comparative study (February 2022-April 2024) including adult CHB (HBsAg-positive, HBeAg-negative) or CHD (anti-HDV or HDV-RNA-positive) patients with mobile access and Spanish proficiency. The app offered educational content, medication reminders, quality-of-life questionnaires (CLDQ, FACIT-F, EQ-5D-5L), a chat function and a knowledge test. Sociodemographic, clinical and usage data were analysed. Of 406 patients evaluated (356 CHB, 50 CHD), 277 CHB and 41 CHD patients were eligible. Participation was high (CHB: 88.4%; CHD: 90.2%), with active use in 48.1% and 70.3%, respectively. App users were more often male and Caucasian, and CHD users more frequently had detectable HDV-RNA. Patients with inactive HBV infection were less likely to use the app over the medium term (OR = 0.462, p = 0.003), and those who did use the app missed fewer clinic visits than nonusers (8.4% vs. 18.1%; OR = 0.41, p = 0.016). Among users, 85 were on antiviral therapy, 67% used the medication reminder, and chat use was higher in CHD and in treated patients (p = 0.004). High adherence (68% CHB, 84% CHD) and knowledge gains were observed, particularly in CHB with higher education. CHD patients showed worse baseline quality of life and greater declines over time. This first real-world study of a tailored mobile health (mHealth) app for CHB and CHD showed improved patient knowledge, adherence, communication and quality-of-life monitoring, with greater engagement in patients with advanced disease.
Hepatitis B Virus Infection and the Risk of Cardiovascular Disease: Findings From the China Kadoorie Biobank.
Wang CR, Zhu Q, Jing FC … +2 more , Tang SX, Zhong GC
J Viral Hepat · 2026 Mar · PMID 41724869 · Publisher ↗
The existing evidence on the association of hepatitis B virus (HBV) infection with the risk of cardiovascular disease (CVD) is limited and mixed. Moreover, no epidemiological studies have been conducted to comprehensivel...
The existing evidence on the association of hepatitis B virus (HBV) infection with the risk of cardiovascular disease (CVD) is limited and mixed. Moreover, no epidemiological studies have been conducted to comprehensively investigate this association in China. Hence, we performed a nationwide prospective cohort study to address these issues. Our study included 477,126 adults without a history of CVD. Participants were recruited from 10 diverse areas in China during 2004-2008, and followed up through December 31, 2016. Adjusted hazard ratio (HR) for CVD incidence was calculated using Cox regression. Subgroup analyses were conducted to identify the potential effect modifiers. During a mean follow-up of 9.94 years, 32,841 ischemic heart disease events, 35,532 ischemic strokes, 5538 intracerebral haemorrhages, 3165 acute myocardial infarction events, and 2939 heart failure events were observed. HBsAg-positive participants had a lower risk of ischemic heart disease [HR: 0.91, 95% confidence interval (CI): 0.84, 0.98; p: 0.011] but a higher risk of intracerebral haemorrhage (HR: 1.25, 95% CI: 1.07, 1.46; p: 0.004) than HBsAg-negative participants. These associations could not be modified by age, sex, study area, body mass index, regular alcohol intake, regular smoking, and physical activity level, and remained in a series of sensitivity analyses. No significant associations were found for ischemic stroke, acute myocardial infarction, and heart failure in the whole study population. In conclusion, HBV infection confers a decreased risk of ischemic heart disease but an increased risk of intracerebral haemorrhage in this Chinese population. More studies are needed to clarify the corresponding mechanisms.
All-Cause Mortality in Persons With HIV-HBV Co-Infection Treated for HBV in Rwanda: A Population-Based Cohort Study.
Makuza JD, Law M, Puyat J … +11 more , Ramji A, Jeong D, Morrow RL, Adu PA, Nisingizwe MP, Issanov A, Cua G, García HAV, Berabose C, Tuyishime A, Janjua NZ
J Viral Hepat · 2026 Mar · PMID 41724728 · Full text
Chronic hepatitis B virus (HBV) infection increases the risk of cirrhosis, hepatocellular carcinoma and non-liver complications. HIV co-infection accelerates disease progression and increases mortality risk compared to H...
Chronic hepatitis B virus (HBV) infection increases the risk of cirrhosis, hepatocellular carcinoma and non-liver complications. HIV co-infection accelerates disease progression and increases mortality risk compared to HBV mono-infection, but its impact among treated individuals is not well documented in Sub-Saharan Africa. We evaluated all-cause mortality among people with chronic HBV on treatment and assessed the effect of HIV/HBV co-infection. A retrospective cohort study using data from Rwanda's District Health Information System 2 included individuals aged ≥ 2 years treated for HBV between January 2016 and June 2022. Follow-up began 12 months after treatment initiation until death or 30 June 2023. Crude mortality rates were calculated, and multilevel Cox proportional hazards regression, accounting for hospital clustering, assessed the impact of HIV/HBV co-infection on all-cause mortality. Among 4843 people who received HBV treatment (3905 with HBV mono-infection and 838 with HIV/HBV co-infection), median follow-up was 3.8 (interquartile range 2.8) years. Thirty-four deaths occurred, yielding an overall crude mortality rate of 1.6 per 1000 person-years (PY). Mortality rate was higher among individuals with HIV/HBV co-infection compared to those with HBV mono-infection (3.3 vs. 1.1 per 1000 PY, respectively). HIV/HBV co-infection was associated with increased all-cause mortality (adjusted hazard ratio 4.07, 95% confidence interval: 1.71, 9.69). Mortality was low among HBV-treated individuals in Rwanda. However, HIV co-infection significantly increased mortality risk, highlighting the importance of closer follow-up of individuals with HIV/HBV co-infection and further studies on the role of HIV viral load suppression.
Hepatitis E Infection in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis.
Kogias D, Kouklakis G, Papadopoulos V
J Viral Hepat · 2026 Mar · PMID 41721452 · Full text
Opportunistic infections are increasingly recognised in patients with inflammatory bowel disease (IBD), particularly among those receiving immunosuppressive therapy. Hepatitis E virus (HEV) is a leading cause of acute vi...
Opportunistic infections are increasingly recognised in patients with inflammatory bowel disease (IBD), particularly among those receiving immunosuppressive therapy. Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis worldwide, yet its relevance in IBD remains insufficiently clarified. This systematic review and meta-analysis aimed to explore the association between HEV infection and IBD. A comprehensive literature search was performed in PubMed/MEDLINE and Google Scholar up to May 2025, identifying all studies reporting HEV infection in patients with ulcerative colitis (UC) or Crohn's disease (CD), with or without a control group. Study quality was assessed using the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies. Six eligible studies encompassing 1316 IBD patients were included in the qualitative and quantitative synthesis. The pooled prevalence of anti-HEV IgG (HEV-G) antibodies among IBD patients was 13.5%, though with notable heterogeneity. Anti-HEV IgM (HEV-M) and HEV-RNA positivity rates were significantly lower, at 1.9% and 0.03%, respectively. When compared with the general population, IBD patients exhibited similar HEV-G and HEV-M prevalence, and comparable rates were observed between UC and CD subgroups. In contrast, immunocompromised transplant recipients demonstrated markedly higher HEV seropositivity. Sensitivity analyses confined to European cohorts indicated a modest rise in HEV-G and HEV-M levels, particularly among patients receiving intensified immunosuppression. Clinically, unexplained elevations of liver enzymes in IBD should prompt consideration of HEV infection. Overall, HEV prevalence in IBD parallels that of the general population; however, severe immunosuppression may predispose to persistent infection or liver-related complications, warranting routine testing for accurate diagnosis.
Hepatic Steatosis Inhibits Hepatitis B Virus Replication by Promoting miR-122-5p-SOX4.
Ren G, Jia K, Yi S … +3 more , Yin S, Huang G, Zhu Y
J Viral Hepat · 2026 Mar · PMID 41721392 · Publisher ↗
The rising prevalence of chronic hepatitis B (CHB) and metabolic dysfunction-associated fatty liver disease (MAFLD) comorbidity necessitates a deeper understanding of their clinical interplay. Although miR-122 is a known...
The rising prevalence of chronic hepatitis B (CHB) and metabolic dysfunction-associated fatty liver disease (MAFLD) comorbidity necessitates a deeper understanding of their clinical interplay. Although miR-122 is a known liver-specific regulator of chronic liver diseases, its specific role in the context of CHB-MAFLD remains elucidated. In this study, serum analysis revealed that CHB-MAFLD patients exhibit significantly lower levels of HBV DNA, pgRNA, and HBsAg compared to patients with CHB alone, which correlated with elevated miR-122 expression. Through bioinformatics and molecular assays, SOX4 was identified as a direct downstream target of miR-122-5p. Utilizing an HBV-infected steatotic cell model, we observed that the comorbid state suppresses HBV replication markers-including DNA, pgRNA, HBsAg, and HBcrAg-while concurrently upregulating the miR-122-5p/SOX4 axis. Functional experiments demonstrated that miR-122-5p and SOX4 both act as inhibitors of HBV activity, as their knockdown enhanced viral replication, while their overexpression led to significant suppression. These findings suggest that the metabolic environment in CHB-MAFLD may naturally suppress HBV replication through the activation of a novel miR-122/SOX4 regulatory axis. This study highlights miR-122 as a potential therapeutic target and provides a mechanistic basis for the altered viral kinetics observed in patients with dual liver pathology. Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR2200063555.
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