Journal Of Viral Hepatitis[JOURNAL]
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200 papers
Regional Comparisons of the Prevalence and Socioeconomics of Hepatitis Delta Virus in Two Southern California Counties.
Pak K, Leng M, Nguyen J … +4 more , Moussa K, Gish R, Han SH, Pockros P
J Viral Hepat · 2026 Mar · PMID 41704203 · Publisher ↗
The global prevalence of chronic hepatitis D virus (HDV) is estimated to be 4%-5%. Our aim was to determine the prevalence of HDV exposure in patients with chronic hepatitis B (CHB) in three different healthcare systems...
The global prevalence of chronic hepatitis D virus (HDV) is estimated to be 4%-5%. Our aim was to determine the prevalence of HDV exposure in patients with chronic hepatitis B (CHB) in three different healthcare systems based in San Diego (SD) County and Los Angeles (LA) County of California. We retrospectively reviewed all adult CHB patients screened for anti-HDV IgG antibody (HDV Ab) who were seen from 2010 to 2024 in the hepatology clinics at Scripps Clinic (SC) in La Jolla, California, and La Maestra Clinic (LM) in SD, and from 2019 to 2023 at UCLA. We determined the median household income by ZIP Code to stratify all patients by socioeconomic status (SES). At SC, 593 of 2441 patients with CHB were screened for HDV. A total of 14 patients tested positive for HDV Ab (2.4%). Two of the 14 patients had detectable HDV RNA. At LM, 118 of 312 patients with CHB were screened for HDV and three patients had a positive HDV Ab (2.5%). None had detectable HDV RNA. At UCLA, 234 of 267 patients with CHB were screened for HDV, and 10 patients had a positive HDV Ab (4.3%). One patient had detectable HDV RNA. Most patients screened at LM, SC, and UCLA belonged to the lowest median yearly income ($75,281), middle ($101,105), and high ($123,271) categories, respectively. There was no statistically significant difference in the prevalence of HDV Ab among each cohort. Of almost a thousand CHB patients who were screened for HDV exposure across three healthcare systems, the prevalence of HDV Ab-positive patients was 2.4%-4.3% without statistically significant differences. Patients from LM, SC, and UCLA were representative of low, middle, and high socioeconomic groups, respectively. This suggests that SES may be less of a risk factor for HDV infection. The HDV PCR-positive (chronic infection) rates were low, ranging from 0% to 0.4%.
Refining Risk Stratification for Oesophageal Varices in HCV-Related Cirrhosis: A Comprehensive Analysis of the Albumin Platelet Product and Elastography Biomarkers.
Elsabaawy M, Naguib M, Magdy M … +2 more , Shaban A, Zayed E
J Viral Hepat · 2026 Mar · PMID 41674297 · Publisher ↗
The albumin platelet product (APP) has recently been explored as a non-invasive marker of liver fibrosis, but its potential to predict portal hypertension and oesophageal varices (OVs) remains under-evaluated. This study...
The albumin platelet product (APP) has recently been explored as a non-invasive marker of liver fibrosis, but its potential to predict portal hypertension and oesophageal varices (OVs) remains under-evaluated. This study aimed to assess the diagnostic accuracy of APP in predicting and grading OVs in cirrhotic patients and to compare its performance with established serum indices and elastography-based measures. A total of 372 patients with HCV-related liver cirrhosis underwent upper endoscopy for OV assessment. APP was calculated and evaluated alongside liver stiffness (LS), spleen stiffness (SS), aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4). In the derivation cohort, APP demonstrated an AUROC of 0.80 (95% CI: 0.75-0.86) for detecting OVs, comparable to LS (0.82; 95% CI: 0.76-0.88) and superior to SS (0.78; 95% CI: 0.71-0.84), FIB-4 (0.68; 95% CI: 0.61-0.74) and APRI (0.66; 95% CI: 0.60-0.72). In the validation cohort, APP maintained a robust performance (AUROC 0.79; 95% CI: 0.73-0.85), confirming reproducibility. For high-risk (large) varices, APP achieved an AUROC of 0.87 (95% CI: 0.82-0.93), outperforming LS (0.83; 95% CI: 0.77-0.89) and SS (0.85; 95% CI: 0.79-0.91). Accordingly, the APP demonstrates superior accuracy over liver and spleen stiffness in predicting oesophageal varices among patients with HCV-related cirrhosis, offering a cost-effective, non-invasive alternative within this population.
Setting the Record Straight: Utility and Outcomes in Patients With HCV Related HCC.
Guerra-Veloz MF, Shah S, Emmanouil B … +8 more , Olsen M, George R, Selemani S, Ross PJ, Carey I, Mehta N, Gillyon-Powell M, Agarwal K
J Viral Hepat · 2026 Mar · PMID 41665509 · Publisher ↗
The effectiveness of direct acting antiviral (DAA) therapy in patients with active hepatocellular carcinoma (HCC) is poorly defined. NHS England approved DAA therapy for all viraemic patients, including those with HCC. T...
The effectiveness of direct acting antiviral (DAA) therapy in patients with active hepatocellular carcinoma (HCC) is poorly defined. NHS England approved DAA therapy for all viraemic patients, including those with HCC. The aim of this retrospective study is to provide a real-life data of treatment outcomes in those with active HCC. Patients with HCV related HCC from the National Hepatitis C registry in South-East England between 2016 and 2023 were included. The primary outcome was to assess the HCV care cascade in patients with HCV related HCC (HCC cohort) in comparison with those with advanced fibrosis/cirrhosis without HCC (non-HCC cohort). 1518 HCV RNA-positive patients started DAA therapy. 92.4% (1403) were included in the non-HCC cohort and 7.6% (115) were included in the HCC cohort. The SVR rate in the HCC cohort was 87% (80/92) versus 94.5% (1126/1191) in the non-HCC cohort (p = 0.003). In the multivariate analysis, only the presence of HCC (OR 0.4 95% CI 0.2-0.9; p = 0.029) was associated with a lower probability of achieving SVR. SVR rates were 95.6%, 50%, 75% and 22.2% and the median overall survival (OS) was 80, 29, 17 and 3 months for BCLC 0-A/B/C/D respectively. OS was longer in those who achieved SVR. More than two thirds of patients with HCV-related HCC initiated and completed DAA therapies. This high level of treatment uptake has led to an acceptable cure rate. Treating patients with HCV and HCC should be viewed as an appropriate clinical standard to improve overall outcomes. However, DAA therapy should not be initiated in those with a short life expectancy.
Real-World Impact of a Simplified 'Test and Treat' Strategy for In-Hospital HCV Micro-Elimination.
You C, Diao Y, Tang J … +7 more , Tang J, Deng W, Zheng C, Liao D, Song D, Wang J, Pu Y
J Viral Hepat · 2026 Mar · PMID 41664555 · Full text
Hepatitis C virus (HCV) micro-elimination faces challenges from fragmented care pathways, particularly in high-prevalence regions with complex genotypes and socioeconomic barriers. This study evaluated a simplified 'Test...
Hepatitis C virus (HCV) micro-elimination faces challenges from fragmented care pathways, particularly in high-prevalence regions with complex genotypes and socioeconomic barriers. This study evaluated a simplified 'Test and Treat' (TNT) strategy to enhance in-hospital HCV micro-elimination by reducing delays and improving linkage to care. Outcomes including HCV RNA testing rates, treatment uptake rates, time to treatment initiation and sustained virological response at 12 weeks (SVR12) of Pre-TNT (Jan. 2022-Dec. 2022) and post-TNT (Jan. 2023-Dec. 2024) were compared. Following TNT implementation, among 168,527 screened patients, the HCV RNA testing rate increased to 93.96% (2070/2203) from 68.17% under pre-TNT, and the treatment rate among viremic patients rose to 81.98% (678/827) from 63.05%. The median time to treatment initiation was dramatically reduced from 12.5 to 3.8 days. SVR12 remained high, with a rate of 99.71%. Barriers among untreated patients were investigated via surveys and follow-ups. Surveys of 500 HCV antibody positive patients revealed limited affordability (only 5% could bear costs > ¥8000) and low health literacy (only 39% knew about prevention and treatment). Among 149 untreated viremic patients, financial constraints and the perception that treatment was unnecessary while asymptomatic were key refusal reasons. The in-hospital streamlined TNT strategy significantly improved HCV RNA testing linkage and treatment uptake, markedly reduced time to treatment initiation and achieved near-universal cure, surpassing WHO treatment targets. Its effectiveness supports broader adoption in high-prevalence regions, though complementary interventions addressing affordability and health literacy are needed for further progress.
A Community-Engaged Approach to Identifying and Addressing Viral Hepatitis Determinants in Michigan Asian American Communities.
Wongsirisakul P, Parikh ND, Troost J … +6 more , Par H, Chowdhury T, Zhang Q, Wang YC, Wu TY, Perumalswami PV
J Viral Hepat · 2026 Mar · PMID 41645917 · Full text
Approximately 75% of people infected with the hepatitis B virus (HBV) and hepatitis C virus (HCV) in the United States (U.S.) have yet to be tested, thus leading to the risk of liver disease progression that can be preve...
Approximately 75% of people infected with the hepatitis B virus (HBV) and hepatitis C virus (HCV) in the United States (U.S.) have yet to be tested, thus leading to the risk of liver disease progression that can be prevented by early diagnosis. Asian Americans (AA) are disproportionately infected with HBV and HCV in the U.S., including in the state of Michigan. Using a theory-informed approach, we conducted a bi-level quantitative study to identify determinants of viral hepatitis and liver cancer care and treatment. We drafted and administered surveys to 151 community members across three Michigan AA communities (Burmese, Chinese and Bangladeshi). The results were then presented to a Community Advisory Panel (CAP) comprised of community leaders who suggested interventional adaptations. Survey respondents who had previously tested for viral hepatitis were wealthier, more proficient in English and had immigrated to the U.S. earlier. They also had higher health literacy, more knowledge of HBV transmission and greater self-efficacy. CAP members recommended that education be delivered in a shareable video format to address health literacy and medical access. Additional recommendations included tabling at community events and tailoring programmes to age. Using these data, we can develop a needs-based, culturally targeted intervention to raise awareness, reduce stigma and increase viral hepatitis screening in Michigan AA communities.
Uptake of the Birth Dose HBV Vaccine and Associated Factors Among Children in Sub-Saharan Africa: An Analysis Using Recent Demographic and Health Survey Data.
Gebrehana AK, Asnake AA, Seifu BL … +7 more , Fente BM, Melkam M, Bezie MM, Tsega SS, Negussie YM, Asebe HA, Asmare ZA
J Viral Hepat · 2026 Mar · PMID 41631779 · Publisher ↗
The hepatitis B virus birth dose vaccine (HepB-BD) is administered within the first 24 h after birth. When given during this period, along with at least two additional doses, it effectively prevents perinatal HBV infecti...
The hepatitis B virus birth dose vaccine (HepB-BD) is administered within the first 24 h after birth. When given during this period, along with at least two additional doses, it effectively prevents perinatal HBV infection and induces immunity. Hepatitis B virus (HBV) infection is a significant public health problem that can cause substantial mortality and morbidity worldwide. The uptake of the HepB-BD vaccine varies across different regions, with more than 70% birth dose coverage observed only in the Americas and the Western Pacific regions. In contrast, coverage in the African Region is generally low, and sub-Saharan Africa (SSA) experiences even lower coverage than the region as a whole. Despite its importance, there is a lack of evidence regarding the uptake of the HepB-BD in SSA. Therefore, this study aimed to assess the prevalence and factors associated with the uptake of the birth dose HBV vaccine among children in SSA. In this study, we used the recent Demographic and Health Survey (DHS) dataset from 2015 to 2023 for seven SSA countries. STATA version 17 software was used for data analysis. After assessing the Intraclass Correlation Coefficient (ICC) and performing the Likelihood Ratio (LR) test, we determined that applying multilevel analysis to account for the hierarchical or nested structure of the DHS data did not provide a significantly better fit than the simpler logistic regression model. As a result, we used the rare-event logistic regression model in our analysis. A Hosmer-Lemeshow test was conducted (Prob > χ = 0.4763), which suggested that the logistic regression model fit the data well. Variables with a p-value of less than 0.25 in the bivariate rare-event logistic regression model were included in the multivariable rare-event logistic regression analysis. Variables with p-values less than 0.05 were considered to be significantly associated with the uptake of the birth dose HBV vaccine. The prevalence of birth-dose HBV vaccine uptake in SSA was 2.76% (95% CI: 0.021-0.036). Children whose mothers were aged 35-39 years (AOR = 4.21, 95% CI: 1.11-5.95) and 40-44 years (AOR = 5.36, 95% CI: 1.15-6.13) had higher odds of receiving the birth-dose HBV vaccine compared with those whose mothers were aged 15-19 years. The odds of receiving the birth-dose HBV vaccine were higher among children whose fathers had higher education (AOR = 2.88, 95% CI: 1.20-8.63) as well as those whose fathers' education level was unknown (AOR = 2.61, 95% CI: 1.25-5.46) compared with children whose fathers had no formal education. Furthermore, children from households in the middle wealth index (AOR = 1.86, 95% CI: 1.23-3.51) had higher odds of receiving the birth-dose HBV vaccine than those from the poorest households. Our study revealed that only about three out of every one hundred children in SSA countries received the birth dose of the HBV vaccine within the first 24 h of delivery. Increased maternal age, higher or unknown paternal education level, and belonging to the middle household wealth index were factors that significantly increased the odds of receiving the HBV birth-dose vaccine among children in SSA countries. Targeted strategies are needed to improve HepB birth-dose coverage, including integrating counselling into maternal health care, involving fathers, ensuring timely facility-based and outreach delivery, targeting younger mothers, improving vaccination record-keeping, and training midwives.
Progress Towards Elimination: Hepatitis B and C Among Children and Young Adults in Rural Mongolia.
Dashdorj ED, Sereenendorj K, Ochirsum B … +14 more , Bat-Ulzii P, Renchindorj B, Dashdorj AN, Budeebazar M, Enkhbat M, Ochirbat E, Lkhagva-Ochir O, Enkhbat A, Bat S, Yagaanbuyant D, Terrault N, Onom NDD, Bungert AS, Dashdorj NB
J Viral Hepat · 2026 Mar · PMID 41623214 · Publisher ↗
Mongolia is a global hotspot for viral hepatitis, with estimated rates of chronic hepatitis B (HBV) of 11% and hepatitis C (HCV) of 8.5% among adults. Data on infections among children and young adults and the impact of...
Mongolia is a global hotspot for viral hepatitis, with estimated rates of chronic hepatitis B (HBV) of 11% and hepatitis C (HCV) of 8.5% among adults. Data on infections among children and young adults and the impact of vaccination against HBV are less clear. In 2018 and 2019, 3800 children and young adults aged 25 and younger from all provinces in Mongolia apart from Ulaanbaatar and Tuv were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), hepatitis B surface antibody (HBsAb), hepatitis C antibody (HCVAb) and hepatitis D antibody (HDVAb). HBsAg positive and serologically positive samples were evaluated for viremia. Risk factors for viral infection were assessed using a questionnaire. In total, 1.34% (51/3800) of participants were HBsAg positive. HBsAg positivity among 20-24 year-olds (5.4%) was 8.8 times higher than in those aged < 19 (0.6%). The prevalence of previous HBV infection was 6.7%. HBsAb without indication of prior infection, reflecting vaccination, was detected in 24.2%, declining with increasing age. Among HBsAg-positive samples, 86% (44/51) had detectable HBV-DNA and 27.45% tested positive for HDVAb (14/51). Only a family history of viral hepatitis was identified as a risk factor. A total of 0.31% (12/3800) of all participants were HCVAb positive. For HBV, the data generally show a much lower infection rate, especially among those born since 1998. Likely, the main reason for this decline is the infant vaccinations against HBV. For HCV, the low number of cases confirms that mostly older Mongolians are affected by HCV.
Viral Hepatitis B, C and Delta in Greenland: A National Cross-Sectional Study.
Naustdal CN, Villadsen GE, Rex KF … +4 more , Krarup HB, Grønbæk H, Pedersen ML, Gantzel RH
J Viral Hepat · 2026 Mar · PMID 41618485 · Publisher ↗
Viral hepatitis B infection is considered endemic in Greenland as in other Arctic areas. However, updated data are warranted after the implementation of screening, vaccination and treatment programmes during the past dec...
Viral hepatitis B infection is considered endemic in Greenland as in other Arctic areas. However, updated data are warranted after the implementation of screening, vaccination and treatment programmes during the past decades. We aimed to investigate the prevalence and disease characteristics of chronic viral hepatitis B (HBV), C (HCV) and delta (HDV) in Greenland. We performed a cross-sectional nationwide study using data from the electronic medical records extracted from 2014 to 2023. We identified 299 patients with HBV (positive of HBsAg) and 45 patients with HCV (positive of HCV-Ab and/or HCV-RNA), corresponding to an overall low prevalence of 0.53% (95%-CI: 0.49%-0.57%) and 0.08% (95%-CI: 0.06%-0.11%), respectively. The prevalence of HDV co-infection (positive of HDV-Ab and/or HDV-RNA) among patients with HBV was 9.4%, of whom 82% were HDV-RNA positive, indicating ongoing infection. Most of these patients were middle-aged and male. Additionally, the occurrence of HBV and HCV was higher among women compared to men in the age category 20-39 years. The most recent liver biochemistry, including Fibrosis-4 (FIB4) score, was within reference values among HBV-positive patients, while alanine and aspartate aminotransferase were slightly elevated among HCV-positive patients. A FIB4 score above 1.3 was observed in 28 (9%) with HBV, 2 (7%) of HBV-HDV positive patients, and 16 (36%) with HCV. The prevalence of HBV infection through routine testing in the healthcare system was markedly lower than prevalences reported in previous population screening studies. Yet, HDV co-infection is common and warrants increased awareness. HCV is rare, but more of these patients have elevated liver enzymes and FIB4 scores.
Tenofovir Alafenamide Fumarate Reduces Virological Replication in HBeAg-Negative Patients With Normal Alanine Aminotransferase: A 48-Week Randomised Controlled Trial.
Luo Q, Xu W, Zhang Y … +9 more , Li X, Lai J, Li J, Zheng X, Deng H, Chen L, Zhu X, Xie C, Peng L
J Viral Hepat · 2026 Mar · PMID 41608776 · Full text
The optimal strategy for chronic hepatitis B virus (HBV) infected patients with negative hepatitis B e-antigen (HBeAg) and normal alanine aminotransferase (ALT) remains uncertain. This study aimed to evaluate the safety...
The optimal strategy for chronic hepatitis B virus (HBV) infected patients with negative hepatitis B e-antigen (HBeAg) and normal alanine aminotransferase (ALT) remains uncertain. This study aimed to evaluate the safety and efficacy of tenofovir alafenamide fumarate (TAF) treatment in this patient population. This prospective, open-label, randomised controlled trial enrolled HBeAg-negative patients with normal ALT and randomised them 1:1 to either the treatment group (TAF) or the control group (no treatment). The primary endpoint was the reduction in hepatitis B surface antigen (HBsAg) levels from baseline to week 48. A total of 62 patients were enrolled and followed up by 48 weeks (n = 31 per group). No serious adverse events were reported. At week 48, there was no significant difference in the change in HBsAg between the treatment and control groups [0.01 (-0.06, 0.05) vs. -0.05 (-0.12, 0.06) log IU/mL, p = 0.354]. However, HBV DNA levels were significantly lower in the treatment group (0 vs. 2.86 log IU/mL, p < 0.001). All patients achieved HBV DNA below 20 IU/mL after treatment. Additionally, chitinase-3-like protein 1 level was lower in the treatment group (23.8 vs. 44.8 ng/mL, p = 0.019). TAF was well-tolerated in HBeAg-negative patients with normal ALT and low-level HBV DNA viremia. Treatment for 48 weeks led to a high rate of HBV DNA suppression and may potentially delay liver fibrosis progression. Accordingly, early antiviral treatment may benefit this patient population. Trial Registration: Clinical trial number: NCT04231565.
HCV Cure: To Bridge the Gaps in the Care Continuum.
Pol S, Ouzan D, Cattan L
J Viral Hepat · 2026 Mar · PMID 41603518 · Publisher ↗
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Synchronous Telemedicine Versus In-Person Care in Hepatitis C Treatment: A Systematic Review and Meta-Analysis.
Silveira IB, Silva GP, Sampaio AVH … +4 more , Tomé MR, Chen JE, de Jesus AVS, Cançado GGL
J Viral Hepat · 2026 Mar · PMID 41603321 · Full text
Inequitable access to HCV treatment persists, particularly for rural and marginalised populations. Synchronous telemedicine (TM) could mitigate access barriers, but its comparative effectiveness versus in-person care is...
Inequitable access to HCV treatment persists, particularly for rural and marginalised populations. Synchronous telemedicine (TM) could mitigate access barriers, but its comparative effectiveness versus in-person care is uncertain. We performed a systematic review and meta-analysis comparing synchronous TM with in-person care for HCV. The primary outcome was sustained virologic response (SVR); secondary outcomes were treatment initiation and completion. Subgroup analyses examined study design, therapy era (interferon vs. direct-acting antivirals [DAAs]), and setting (rural vs. non-rural). Narrative synthesis addressed people who use drugs (PWUD), incarcerated populations, pandemic-era cohorts, and economic evaluations. Fifteen studies involving 7.459 patients (2 RCTs, 13 observational) were included (13 meta-analysed). For SVR, the pooled effect showed no significant difference between interventions (odds ratio [OR] 1.60, 95% CI 0.69-3.68). Treatment initiation and completion were also not significantly different overall (initiation OR 7.59, 95% CI 0.79-72.81; completion OR 2.50, 95% CI 0.76-8.25), although exclusion of single influential studies yielded significant benefits for TM in sensitivity analyses. Subgroups suggested context-specific advantages: TM favoured SVR in rural settings (OR = 4.19, 95% CI 1.28-13.73) and in RCTs (OR = 10.42, 95% CI 7.41-14.67). Narrative evidence indicated that TM improved linkage and cure among PWUD and incarcerated individuals, preserved efficacy during COVID-19, and reduced costs. Overall, synchronous TM seems comparable to in-person care overall and may be superior in rural and marginalised populations.
Impact of Direct-Acting Antivirals Availability on Hepatitis C-Related Hospitalisations After Eight Years of the Strategic Plan for Tackling Hepatitis C Implementation in Spain.
Garrido-Estepa M
J Viral Hepat · 2026 Mar · PMID 41603319 · Publisher ↗
The Strategic Plan for Tackling Hepatitis C launched by the Ministry of Health in 2015 led to an important nationwide decrease in chronic hepatitis C-related hospitalisation rates by 2018 (25.8% of decrease compared to 2...
The Strategic Plan for Tackling Hepatitis C launched by the Ministry of Health in 2015 led to an important nationwide decrease in chronic hepatitis C-related hospitalisation rates by 2018 (25.8% of decrease compared to 2014 rates). This work aims to actualize the results on hepatitis C hospitalisation burden in Spain until 2023. Chronic HCV-related hospitalisation discharges from 2014 to 2023 were obtained from the Registry of Specialised Health Activity. A descriptive analysis of the hospitalisations was performed. All chronic, advanced liver disease (AdLD), and non-AdLD (N-AdLD) hospitalisation rates (HRs) were calculated at national and regional level. Hospitalisation rate ratios using 2014 as reference year were calculated using a Poisson model. From 2014 to 2023 there were 374,222 chronic HCV-related hospitalisations: 267,920 (71.6%) with N-AdLD and 106,302 (28.4%) with AdLD. Overall in-hospital fatality rate was 6.8%. In 2023, compared to 2014, national HRs decreased 49.7% (95% CI: 49.0% to 50.4%) for all chronic, 43.3% (95% CI: 42.4% to 44.3%) for N-AdLD and 62.6% (95% CI: 61.5% to 63.6%) for AdLD. At regional level, 10/19 Spanish regions achieved a decrease in the HRs of > 40%-60% and 1/19 of > 60%-80% for N-AdLD. For AdLD, 14/19 of the regions achieved a decrease in the HRs of > 60% (one of them, Ceuta, > 80% of decrease) and 3/19 a decrease of > 40%-60%. Following the implementation of the Strategic Plan, the hospital burden due to chronic HCV has continuously decreased in Spain. By 2023, the hospitalisation rate for chronic cases has been reduced to half.
Epidemiology and Control of Widespread Community Hepatitis A Outbreaks in 37 U.S. States, 2016-2023.
Hofmeister MG, Yin S, Dokpesi P … +4 more , Teshale EH, Eckert M, Gupta N, Hepatitis A Outbreak Investigation Group
J Viral Hepat · 2026 Feb · PMID 41578878 · Publisher ↗
During 2016-2023, 37 U.S. states experienced hepatitis A outbreaks associated with person-to-person transmission. We sought to describe the epidemiology of the outbreaks and characterise outbreak response efforts over ti...
During 2016-2023, 37 U.S. states experienced hepatitis A outbreaks associated with person-to-person transmission. We sought to describe the epidemiology of the outbreaks and characterise outbreak response efforts over time. We analysed outbreak databases from 37 states, survey responses from 33 states, and hepatitis A case reports from the National Notifiable Diseases Surveillance System for all 50 states and Washington, DC, during August 1, 2016-December 31, 2023. Among 44,930 reported outbreak-associated cases, most occurred among males (62%), non-Hispanic White persons (65%), and those aged 30-49 years (54%); 62% were hospitalised and 1% died. Commonly reported risk factors for HAV infection were drug use (53%) and homelessness or unstable housing (14%). Sixty-seven percent of adults had a documented indication for hepatitis A vaccination. In late 2017, CDC stood up a national incident management system to coordinate communication between outbreak-affected states, facilitate vaccine delivery, and provide technical assistance. States with available data reported administering more than 5.3 million adult hepatitis A vaccines collectively; most states administered vaccines in correctional facilities, local health departments and homeless shelters. Outbreak-associated cases peaked in 2019 and then declined annually. As outbreak response capacity scaled up nationwide, states with later outbreak start dates tended to experience smaller outbreaks than those with earlier start dates. Unprecedented hepatitis A outbreaks were controlled by a robust vaccine response in 37 states. Continued vigilance and providing access to vaccination for recommended populations will be critical to preventing similar outbreaks in the future.
Peer Interventions for Hepatitis C Testing and Treatment in OECD Countries: A Systematic Scoping Review.
Daly S, Reid L, Buchanan R … +4 more , McCulloch P, Flowers P, Frankis J, Vojt G
J Viral Hepat · 2026 Feb · PMID 41578687 · Full text
Services delivered by peer workers (people with lived/living experience) are recommended to find, test, and treat those at risk of hepatitis C (HCV). However, there is a lack of knowledge around the characteristics and u...
Services delivered by peer workers (people with lived/living experience) are recommended to find, test, and treat those at risk of hepatitis C (HCV). However, there is a lack of knowledge around the characteristics and underlying mechanisms of existing HCV peer interventions and how these drive effectiveness and impact. This systematic scoping review aimed to identify the activities of peer interventions, their reported outcomes, and mechanisms of change. We systematically searched five databases (Scopus, PubMed, Embase, PsycINFO and Web of Science) for peer-reviewed papers which described HCV peer interventions in OECD countries published between 2012 and 2022, informed and structured by the PRISMA extension for scoping reviews and scoping review reporting guidance. All identified studies were double screened at title and abstract and full text stage. Twenty-nine studies met our inclusion criteria. In 23 studies, peer workers delivered interventions, mostly focused on outcomes for intervention recipients. Peer workers improved HCV care linkage, testing, treatment and SVR12 rates. Peer workers themselves reported increased confidence, job satisfaction, improved mental wellbeing, employability and social integration into communities. Key activities and peer intervention elements were occasionally documented, but more often omitted. None of the included studies explicitly documented or theorised underlying mechanisms, that is, how or why peer interventions work. The lack of details and mechanistic descriptions of peer interventions negatively impact the ability to optimise and enhance peer-led HCV care. This potentially undermines the elimination of HCV at population level.
Response to Comments on 'Hepatitis B Virus (HBV) Treatment Eligibility in the UK: Retrospective Longitudinal Cohort Data to Explore the Impact of Changes in Clinical Guidelines'.
Campbell C, Wang T, Barnes E … +2 more , Matthews PC, UK Health Informatics Collaborative for Viral Hepatitis and Liver Disease
J Viral Hepat · 2026 Feb · PMID 41574432 · Full text
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Prevalence of Hepatitis B Among Migrants Living in High-Income Countries With Low/Intermediate HBV Prevalence-A Systematic Review and Meta-Analysis.
Sun J, Pourmarzi D
J Viral Hepat · 2026 Feb · PMID 41562241 · Publisher ↗
The World Health Organisation targeted the Hepatitis B virus (HBV) for elimination as a public health threat by 2030. To achieve this goal, equitable access to HBV testing and treatment services is critical. Migrants usu...
The World Health Organisation targeted the Hepatitis B virus (HBV) for elimination as a public health threat by 2030. To achieve this goal, equitable access to HBV testing and treatment services is critical. Migrants usually experience multiple barriers to accessing HBV services. Understanding HBV prevalence among this population can support planning for HBV elimination. This systematic review aimed to estimate HBV prevalence among migrants in high-income countries with low/intermediate HBV prevalence. PubMed, Scopus, PsycINFO and Cochrane Library were searched for peer-reviewed studies published between 2015 and 2025 in English. The Joanna Briggs Institute (JBI) Critical Appraisal Tools were used for methodological quality assessment. A proportional meta-analysis was used to estimate HBV prevalence. We also estimated the prevalence of HBV surface antibody (anti-HBs) positive from the included studies. Forty-four studies were included in this review. The pooled HBV surface antigen (HBsAg) and anti-HBs prevalence were 4.4% (95% CI: 3.4%-5.5%) and 35.2% (95% CI: 26.9%-44.0%), respectively. HBsAg prevalence was higher in males (5.8%) than in females (2.4%). Migrants aged 18 years and over had higher HBsAg prevalence than those aged less than 18 years (3.5% vs. 2.1%). Among refugees and asylum seekers, HBsAg and anti-HBs prevalence were 4.2% and 31.2%, respectively. The HBV prevalence among migrants was comparable to the global level, but higher than that in the general population of countries included in this study. To improve equity in HBV elimination strategies, migrants, especially refugees and asylum seekers' access to HBV information, testing, and treatment should be facilitated.
The State of Hepatitis B in Florida in 2025: Current Challenges and Health Disparities.
Nejat C
J Viral Hepat · 2026 Feb · PMID 41549959 · Full text
Hepatitis B virus (HBV) infection remains a significant public health challenge in Florida despite advancements in prevention and treatment. This review analyses the current epidemiology, disease burden and management st...
Hepatitis B virus (HBV) infection remains a significant public health challenge in Florida despite advancements in prevention and treatment. This review analyses the current epidemiology, disease burden and management strategies for hepatitis B in Florida as of 2025, drawing on state surveillance data and recent public health reports. Florida continues to experience higher rates of both acute and chronic hepatitis B compared to national averages, with pronounced racial, ethnic and geographic disparities. Rural areas face disproportionately high rates of acute infections, while chronic infections are more concentrated in urban centres. Despite established prevention strategies-including vaccination, perinatal prevention programs and adult testing initiatives-critical gaps persist in service delivery and care engagement. This review also highlights the growing challenges posed by declining childhood immunisation rates and limited harm reduction services in high-burden areas. Finally, we examine Florida's progress toward the World Health Organization's 2030 hepatitis elimination targets, underscoring the urgent need for expanded screening, improved linkage to care and strategies that address the social determinants driving transmission.
Challenges of an EMR-Based Hospital Alert Program for Micro-Elimination of Hepatitis C in Tertiary Referral Hospitals.
Kim HY, Lee HL, Nam H … +17 more , Lee SK, Han JW, Yang H, Lee A, Sung PS, Kim SH, Lim J, Song DS, Song MJ, Jang JW, Chang UI, Kim CW, Nam SW, Bae SH, Yoon SK, Kwon JH, Lee SW
J Viral Hepat · 2026 Feb · PMID 41532395 · Publisher ↗
Despite advances in hepatitis C virus (HCV) treatments, diagnostic gaps and linkage-to-care hinder elimination efforts. We evaluated an electronic medical record (EMR)-based automated alert system to improve HCV care at...
Despite advances in hepatitis C virus (HCV) treatments, diagnostic gaps and linkage-to-care hinder elimination efforts. We evaluated an electronic medical record (EMR)-based automated alert system to improve HCV care at tertiary referral centers. We have screened 1,303,578 patients who were tested for anti-HCV, and analyzed 8291 patients positive for anti-HCV antibody (Ab) across four tertiary hospitals between July 2009 and December 2023. The EMR alert system, implemented in June 2021, identified patients with positive anti-HCV antibody results who had not undergone HCV ribonucleic acid (RNA) testing. We compared HCV RNA testing rates, linkage-to-care and time intervals between testing before and after system implementation. The HCV RNA test prescription rate increased from 60.5% in the pre-alert period to 66.9% in the post-alert period. In non-hepatology departments, the prescription rate increased from 47.1% to 60.5%. The interval between HCV Ab positivity to HCV RNA test prescription in patients without initial HCV RNA order decreased significantly from 1208.9 to 244.5 days. Among 732 previously HCV RNA untested patients who were followed up after alert implementation, 43.4% received HCV RNA testing, leading to 62 new HCV diagnoses. The referral rate to hepatology departments remained stable (83.3% pre-alert vs. 80.9% post-alert). In conclusion, implementation of an EMR-based alert system effectively improved HCV diagnostic rates and reduced testing delays, particularly in non-hepatology departments. This system represents a promising strategy for hospital-based HCV micro-elimination, but additional interventions might be needed to achieve optimal testing rates and linkage-to-care.
Identifying and Linking to Care and Treatment Persons With Hepatitis C Who Were Lost to Follow-Up, Georgia 2023-2024.
Getia V, Imnadze P, Adamia E … +7 more , Tsereteli M, Alkhazashvili M, Surguladze S, Schumacher IT, Glass N, Shadaker S, Tohme RA
J Viral Hepat · 2026 Feb · PMID 41532389 · Full text
In 2015, Georgia launched a hepatitis C elimination programme with free screening and treatment. However, a large number of persons were lost to follow up after screening for, or diagnosis with, hepatitis C virus (HCV) i...
In 2015, Georgia launched a hepatitis C elimination programme with free screening and treatment. However, a large number of persons were lost to follow up after screening for, or diagnosis with, hepatitis C virus (HCV) infection. During February 2023-September 2024, we conducted active outreach to reengage persons who were lost to follow-up in care and assess barriers to hepatitis C care and treatment through questionnaires covering pre- and post-outreach perceptions. Among 18,034 persons who tested HCV antibody (anti-HCV) reactive but were not tested for HCV viremia and had valid contact information, 14,252 (79%) could be reached, among whom 64% were unaware of their test result. After outreach, 4593 (32%) completed HCV viremia testing, among whom 2440 (53%) tested positive and 1577 (65%) initiated treatment. Main reasons for not seeking care after active outreach were having another chronic illness (33%) and being unaware they were screened for anti-HCV (23%). Among 13,151 persons diagnosed with HCV infection who did not initiate treatment and had valid contact information, 6982 (53%) were reached, among whom 2267 (33%) initiated treatment. The main reason for not initiating treatment before outreach was lack of information (62%) and after outreach was distrust in the hepatitis C elimination programme (79%). Treatment initiation was more common among those first tested in recent years. Active outreach successfully identified new infections and nearly 40% of those diagnosed initiated treatment. Educating patients about their test results and promptly linking them to care and treatment is essential to achieve hepatitis C elimination.
Association Between Indirect Bilirubin Percentage to Albumin Ratio and Outcome of Hepatitis B Related Acute on Chronic Liver Failure Treated With Artificial Liver Support System.
Tang W, Ma Y, Du L … +2 more , Bai L, Tang H
J Viral Hepat · 2026 Feb · PMID 41510593 · Publisher ↗
This study investigates the impact of the indirect bilirubin percentage-to-albumin ratio (iBAR) on the prognosis of patients with acute-on-chronic liver failure (ACLF), as defined by the Chinese Group on the Study of Sev...
This study investigates the impact of the indirect bilirubin percentage-to-albumin ratio (iBAR) on the prognosis of patients with acute-on-chronic liver failure (ACLF), as defined by the Chinese Group on the Study of Severe Hepatitis B-ACLF (COSSH ACLF) criteria, who were treated with an artificial liver support system (ALSS). In a retrospective cohort of 258 eligible patients, restricted cubic splines, linear regression, and Cox proportional hazards models were used to analyse the association of iBAR with disease severity and 28-day and 90-day outcomes. The 28-day transplant-free and overall survival rates were 76.4% and 82.2%, respectively, while the 90-day rates were 58.5% and 66.3%. The iBAR was significantly lower in 28-day transplant-free survivors compared to those who underwent transplantation or died (6.47 ± 2.95 vs. 8.87 ± 2.49, p < 0.001), with similar findings for 90-day outcomes (6.09 ± 2.75 vs. 8.38 ± 2.88, p < 0.001). A positive association was observed between iBAR and COSSH ACLF score (adjusted β = 0.14, 95% CI: 0.11-0.18, p < 0.001). Furthermore, iBAR was independently associated with higher risks of 28-day transplant-free mortality (adjusted HR = 1.21, 95% CI: 1.10-1.34, p < 0.001), 28-day overall mortality (adjusted HR = 1.26, 95% CI: 1.12-1.42, p < 0.001), 90-day transplant-free mortality (adjusted HR = 1.13, 95% CI: 1.06-1.22, p < 0.001), and 90-day overall mortality (adjusted HR = 1.14, 95% CI: 1.05-1.23, p = 0.002). Patients with an iBAR > 6.13 had significantly poorer 28-day and 90-day prognoses compared to those with iBAR ≤ 6.13 (all adjusted HR > 1, p < 0.05). In conclusion, iBAR is positively associated with disease severity and adverse prognosis in COSSH ACLF patients receiving ALSS therapy, suggesting its potential as a prognostic biomarker that warrants validation in future prospective, multicenter studies.
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