Kamal H, Jargalsaikhan G, Enkhtaivan S
… +9 more, Bruce D, Lindahl K, Dashtseren B, Ulziibadrakh T, Batkhuu M, Bat-Ulzii P, Byambabaatar S, Aleman S, Dashdorj NB
J Viral Hepat
· 2026 Feb · PMID 41492829
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Chronic liver diseases cause a significant burden in Asia. This study aims to characterise the pattern and factors associated with advanced chronic liver disease (aCLD) in a large cohort from Mongolia, which has the high...Chronic liver diseases cause a significant burden in Asia. This study aims to characterise the pattern and factors associated with advanced chronic liver disease (aCLD) in a large cohort from Mongolia, which has the highest rate of liver cancer globally. This is a cross-sectional analysis of HBsAg tested adults (≥ 18 years) with available liver stiffness measurement (LSM) and/or platelet count at initial visit at a hepatology centre, Ulaanbaatar, Mongolia during 2015-2023. Definition of aCLD was LSM ≥ 12.5 kPa or platelet count < 150*10 cells/L. The annual percentage change (APC) of the incidence rates and factors associated with aCLD were assessed via logistic regression models. Out of 17,711 persons identified, 2517 (14.2%) had aCLD at initial visit, with a mean age (±SD) of 50.1 (12.0) years, 23.6% below 40 years old and 53.2% were female. The prevalence of HBsAg+, anti-HDV+, HDV RNA+, and anti-HCV+ was 61.6%, 78.6%, 64.6% and 57.9% in aCLD, respectively. Among aCLD, three-fourths had an intermediate to high 5-year risk of hepatocellular carcinoma (HCC) with 25.0%, and 17.1% having previously received anti-HBV and anti-HCV therapies, respectively. The overall rate of aCLD declined (APC -7.8%), mainly due to decline in anti-HCV+ cases (APC -15.0%), while it significantly increased for anti-HDV+ over study period (APC 3.3%). In a large cohort of attendees at a hepatology centre in Mongolia, the prevalence of aCLD declined associated with decreasing HCV infection, while chronic hepatitis D constituted the majority of increasing cases. A minority received therapy, with most patients showing an intermediate to high risk of liver cancer. More efforts are needed to improve linkage to care and access to therapy, especially in middle-aged individuals at higher risk of liver disease progression.
Barakat EMF, Kohla M, Tawheed A
… +36 more, Shousha HI, Moustafa EF, Said M, Sayed H, Rewisha E, Abdelaziz AO, Abd Elaziz KM, Abdelmalek MO, Dabees H, El Fouly A, Elkhateeb E, Nabeel MM, Eltabbakh M, Riad AR, Nasif A, Abdeen N, Elhelbawy M, Elbaz T, Askar SR, Shoukry M, Khalifa Y, Abdelmaksoud AH, Shamkh MAA, Kaddah M, Abdelrazek YA, Lithy R, Sleem AA, Hashem MB, Abdelaziz AA, Ramadan A, Farid HM, Abdallah NM, Ghazy MS, AbouElmaaty ME, Hassan MS, El-Kassas M
Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) poses significant health challenges globally, particularly in regions with considerable HBV prevalence such as Egypt. Despite immunisation programmes, HBV re...Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) poses significant health challenges globally, particularly in regions with considerable HBV prevalence such as Egypt. Despite immunisation programmes, HBV remains a leading cause of liver cancer in Egypt, often diagnosed at advanced stages, complicating management and worsening prognosis. This retrospective multicentre study included 365 Egyptian patients diagnosed with HBV-related HCC between February 2007 and July 2023 from six tertiary care centres across Egypt. Clinical, laboratory, tumour characteristics, treatment outcomes and overall survival were collected and analysed. Diagnosis was confirmed according to international guidelines using triphasic CT or dynamic MRI. Treatment responses were assessed using modified RECIST criteria, and survival was analysed using Kaplan-Meier curves. Patients had a median age of 59 years, predominantly male (76.4%), and most (98.4%) presented with cirrhosis at diagnosis. The majority were not receiving antiviral treatment (76.71%) at presentation. Intermediate and advanced BCLC stages (B-D) comprised over 75% of cases. Trans-arterial chemoembolization was the primary treatment modality (34.5%), followed by sorafenib (24.1%) and best supportive care (28.8%). Median overall survival was 13.1 months. Independent factors associated with mortality included high ALBI score, positive HBV DNA at diagnosis, and advanced Child-Pugh classification. In conclusion: this study underscores the advanced stage at which HBV-related HCC is typically diagnosed in Egypt and the resulting poor survival outcomes. Strengthening early detection through surveillance programmes, increasing antiviral therapy coverage and adherence to treatment protocols are critical strategies to enhance patient prognosis.
J Viral Hepat
· 2026 Feb · PMID 41482805
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Chronic hepatitis C (CHC) continues to be a significant public health issue in the United States, but comprehensive analysis of its epidemiological characteristics is limited. This analysis used data from the National No...Chronic hepatitis C (CHC) continues to be a significant public health issue in the United States, but comprehensive analysis of its epidemiological characteristics is limited. This analysis used data from the National Notifiable Diseases Surveillance System to examine patterns and changes in newly reported CHC. During 2016-2023, 895,522 CHC cases were newly reported among adults aged ≥ 18 years in the United States. The rate of newly reported cases during 2020-2023 was significantly lower (47.8 cases per 100,000), compared with the rate during 2016-2019 (75.8 cases per 100,000). A distinct bimodal age distribution was observed with age peaks centered at approximately 33.9 and 59.5 years, which corresponds to millennials (born during 1981-1996) and baby boomers (born during 1945-1965), respectively. While the bimodal age distribution persisted, over time, fewer cases contributed to the older peak relative to the younger peak. Males had a significantly higher rate of newly reported CHC than females, as did individuals residing in rural areas compared to urban areas, particularly within the younger peak. Variations in the transition from the older peak to the younger peak were observed across states during 2016-2023. These findings provide valuable insights into the evolving CHC epidemiology and the implications for the efforts to eliminate the disease.
Karichashvili L, Shadaker S, Schumacher IT
… +11 more, Tsereteli M, Alkhazashvili M, Chitadze N, Surguladze S, Merabishvili T, Khoperia A, Averhoff F, Cloherty G, Gogilashvili K, Alkhanishvili Z, Tohme RA
J Viral Hepat
· 2026 Feb · PMID 41454735
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Dental health professionals (DHPs) are at risk for bloodborne viruses. We evaluated hepatitis B and hepatitis C seroprevalence and knowledge, attitudes and practices regarding viral hepatitis in Georgia. We randomly sele...Dental health professionals (DHPs) are at risk for bloodborne viruses. We evaluated hepatitis B and hepatitis C seroprevalence and knowledge, attitudes and practices regarding viral hepatitis in Georgia. We randomly selected 214 dental facilities. DHPs underwent face-to-face interviews and provided blood samples. High knowledge and practice were defined as correctly responding to 70% or more of the questions. Samples were tested for antibodies against hepatitis C virus (anti-HCV) and, if reactive, for HCV RNA; total hepatitis B core antibodies (anti-HBc) and, if reactive, for hepatitis B surface antigen (HBsAg). Specimens reactive for HBsAg were tested for antibody to hepatitis D virus (anti-HDV). Among 519 participants, 6.6% and 7.9% correctly identified all HBV and HCV transmission modes, respectively. Approximately half had high knowledge scores for hepatitis B and hepatitis C. Nurses had lower odds than dentists to have high scores. While 56% agreed that the hepatitis B vaccine is essential for healthcare workers, only 23.9% reported being vaccinated. Overall, 89.4% had high practice scores; 41.6% experienced a blood splash on their face, 43.7% a needle-stick injury and 20.6% an injury with a contaminated instrument. Practice scores were lower among those who had not been screened or vaccinated for hepatitis B. Among 517 blood samples tested, 0.8% were anti-HCV reactive, but none had detectable HCV RNA; 12.2% were anti-HBc reactive and 0.6% were HBsAg reactive. None tested reactive for anti-HDV. Enhanced training and policy reforms are critical to improve hepatitis knowledge, vaccination uptake and infection control practices among DHPs in Georgia.
NéoVie primary objective was to describe the care pathway of patients with HCV infection treated in addiction centres in France, by evaluating the rate of treatments initiated among these patients and to identify obstacl...NéoVie primary objective was to describe the care pathway of patients with HCV infection treated in addiction centres in France, by evaluating the rate of treatments initiated among these patients and to identify obstacles to treatment initiation. Multicentric, prospective, non-interventional study conducted in France from May 2020 to July 2022. Inclusion criteria were age > 18 years, positive HCV RNA, follow up in a participating addiction centre. Direct-acting antiviral (DAA) treatment was initiated at the discretion of the investigators. Patients initiating glecaprevir/pibrentasvir (G/P) treatment were followed for up to 11 months after treatment initiation. Data were collected through specific questionnaires. 32 centres participated in the study and 18 were active. Among the 93 patients included, 89 (95.7%) were treated with a DAA (77 (82.8%) with G/P). After G/P treatment initiation, all but 2 (which were reinfections) achieved SVR 12 and maintained virological response 6 months later. No AEs with a frequency > 3% were reported. Significant improvements were observed between inclusion and 11 months after in terms of quality of life (mean improvement of 6.78 ± 21.53 pts (VAS)) and anxiety and depression (10/37; 27.0% of the patients). These results suggest that once efforts are made in the centre to apply the simplified pathway, it is possible to treat and cure patients with DAA. In order to achieve HCV elimination goal, efforts to promote treatment should continue focusing on training and motivating addiction centres.
Despite long-standing national vaccination recommendations targeting high-risk groups, hepatitis B vaccination (HepB) coverage among US adults remains low. To inform efforts following the 2022 recommendation for universa...Despite long-standing national vaccination recommendations targeting high-risk groups, hepatitis B vaccination (HepB) coverage among US adults remains low. To inform efforts following the 2022 recommendation for universal adult HepB vaccination, we analysed data from the National Health Interview Survey (2000-2018) to estimate national HepB vaccination coverage and identify factors associated with vaccine uptake. We used Poisson regression and a health behaviour framework to examine associations across four domains: Sociodemographic characteristics, healthcare access, health-seeking behaviours, and access to health information. Among 532,168 non-institutionalised US adults aged ≥ 18 years, the self-reported HepB vaccination rate was 27.9% (95% CI 27.6-29.7), increasing from 22% in 2000 to 35% in 2018. Health-related behaviours showed the strongest association with HepB vaccination, including prior hepatitis A vaccination (AOR 11.17, 95% CI 10.51-11.87), prior hepatitis B testing (AOR 4.70, 95% CI 4.47-4.93), and prior hepatitis C testing (AOR 1.28, 95% CI 1.21-1.35). Conversely, older age, lower educational level, and recent unemployment were associated with lower odds of HepB vaccination. Additionally, Black and Hispanic adults had lower odds of vaccination compared to white adults. These findings highlight persistent gaps in HepB vaccine coverage among particular segments of the US population and underscore the importance of vaccination efforts that focus on these communities to mitigate existing disparities and achieve the goal of universal HepB vaccination.
Occult hepatitis B infection (OBI) represents a unique diagnostic and clinical challenge due to undetectable HBsAg despite HBV DNA presence. Genetic mutations, particularly in the HBV S gene, play a crucial role in immun...Occult hepatitis B infection (OBI) represents a unique diagnostic and clinical challenge due to undetectable HBsAg despite HBV DNA presence. Genetic mutations, particularly in the HBV S gene, play a crucial role in immune evasion and diagnostic failures associated with OBI. This cross-sectional study investigated the genetic mutations in the S gene of HBV among family members of chronically infected patients. This study enrolled 243 family members from 62 HBV-infected index cases. Serological assays were used to identify HBsAg and anti-HBc positivity. HBV DNA was amplified and sequenced in 12 cases, focusing on the S gene. The impact of mutations in the S gene was assessed through in silico analyses, including epitope prediction and secondary structure modelling. Of the household contacts, 9.05% were HBsAg-positive and 37.03% were suspected OBI due to anti-HBc positivity. Out of the suspected OBI, 20% of individuals had detectable HBV DNA. Mutations like R122K and V194A were found to be enriched among OBI sequences and were shown to alter immune epitopes without affecting protein structure. Genotype D was predominant in chronic cases, while genotype A was more frequent in OBI. The adw2 serotype was commonly observed in OBI cases. Thus, this study highlights the role of S gene mutations in OBI's diagnostic and immune escape mechanisms. The findings underline the importance of genotype-specific diagnostic approaches and further investigations into the pre-S regions to enhance understanding of HBV pathogenesis.
Razavi-Shearer D, Gamkrelidze I, Hall S
… +9 more, Cohen C, Gish R, Pham T, Razavi-Shearer K, Remak W, Saboui M, Voeller A, Wallace C, Razavi H
J Viral Hepat
· 2026 Jan · PMID 41416586
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Accurate estimates of the prevalence of chronic hepatitis B virus (HBV) in the United States (US) are necessary for policy makers and community-based organisations to make informed decisions regarding the allocation of r...Accurate estimates of the prevalence of chronic hepatitis B virus (HBV) in the United States (US) are necessary for policy makers and community-based organisations to make informed decisions regarding the allocation of resources to work towards the elimination of HBV as a public health threat. The primary aim of this study was to quantify the current HBV prevalence in the US at the state, county, and territorial level. The secondary aim was to quantify which countries of birth lead HBV infections. Using previously validated and published population-based country level Markov models, the prevalence of HBV among immigrants in the US by country of birth was estimated in 2021. These estimates were then applied to county level population estimates from the 2018-2022 American Community Survey. This resulted in new county, state, territorial (Puerto Rico and Washington, D.C.), and national level HBV prevalence estimates. The total number of HBV infections in the US was estimated to be 1.7 million (UI: 795,000-4.1 million) corresponding to a prevalence of 0.50% (UI: 0.24%-1.23%). The state with the highest prevalence was Hawai'i, 1.3% (UI: 0.5%-40%), while Wyoming was estimated to have the lowest prevalence, 0.2% (UI: 0.1%-1.1%). The largest number of total infections was found in California, 347,100 (UI: 193,700-729,200). The Aleutians West Census Area was the county with the highest prevalence, 2.9% (UI: 0.8%-9.7%), while Los Angeles County had the highest number of infections, 96,700 (UI: 54,800-190,600). These data can aid planners at all levels to better understand the complexities of HBV in the US. Thus, providing evidence for targeted public health interventions that will reduce the burden of HBV and improve the lives of those living with the disease.
Wong RJ, Gish RG, Jacobson IM
… +6 more, Lim JK, Rock M, Kinyik-Merena C, Ma H, Smith N, Kim C
J Viral Hepat
· 2026 Jan · PMID 41405233
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Hepatitis D virus (HDV) screening rates in the United States are low. We evaluated the impact of double reflex-based HDV testing on HDV-related morbidity and mortality in the United States. A Screen and Treat model simul...Hepatitis D virus (HDV) screening rates in the United States are low. We evaluated the impact of double reflex-based HDV testing on HDV-related morbidity and mortality in the United States. A Screen and Treat model simulated the HDV screening cascade (decision tree) and assessed the natural history of HDV (Markov model) over a 5-year time horizon from a United States third-party payer perspective, for patients positive for HBV. The number of patients diagnosed with HDV and liver-related outcomes were compared under double reflex screening (100% patients screened for HDV antibodies and HDV RNA) and current practice (11% patients screened for HDV antibodies and 25% anti-HDV-positive patients for HDV RNA). Implementation of HDV double reflex testing predicted a 3655% increase in patients diagnosed versus current practice (n = 7231 vs. n = 193, respectively). The number of predicted occurrences of all liver-related outcomes over 5 years is lower with double reflex testing versus current practice (difference in numbers of events: -7% for compensated cirrhosis, -40% for decompensated cirrhosis, -23% for hepatocellular carcinoma, -34% for liver transplantation, and -32% for liver-related deaths). Results of scenario analyses with varying HBV prevalence, treatment received, or treatment rates were similar. Simulation of double reflex testing predicted earlier detection of HDV patients, increased numbers of patients diagnosed and treated, and reduced rates of disease progression, liver-related complications and deaths. These findings highlight the need for implementing strategies to improve HDV screening and linkage to care and treatment in the United States. Trial Registration: ClinicalTrials.gov identifier: NCT03852719.
J Viral Hepat
· 2026 Jan · PMID 41400072
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Organ transplant recipients are at high risk of developing chronic infection when exposed to hepatitis E virus (HEV), which can rapidly progress to liver fibrosis and cirrhosis. Macrophages play a key role in the respons...Organ transplant recipients are at high risk of developing chronic infection when exposed to hepatitis E virus (HEV), which can rapidly progress to liver fibrosis and cirrhosis. Macrophages play a key role in the response to the infection and disease progression. However, the interactions amongst immunosuppressants, macrophages, the course of HEV infection and activation of inflammatory response remain unclear. In this study, we generated M0, M1 and M2 macrophages from the human THP-1 cell line. These macrophages were then infected with HEV and treated with different immunosuppressants. We visualised viral infection using laser confocal microscopy, and quantitatively analysed viral replication and inflammatory responses by bulk sequencing, RT-qPCR, ELISA and Western blotting. We found that the M1 inflammatory macrophages exhibited the highest, while M2 macrophages had the lowest levels of viral RNA. Genome-wide transcriptome analysis indicated that viral, inflammation and immunity-related pathways were predominantly upregulated by HEV infection. Dexamethasone exerted potent inhibitory effects on inflammatory response in macrophages. Mycophenolic acid (MPA) demonstrated inhibitory effects on viral replication, IL-1β and TNF-α expression, whereas mTOR inhibitors had the opposite effects, and tacrolimus showed no clear effect. In conclusion, immunosuppressants can differentially affect HEV replication and the subsequent inflammatory responses in macrophages.
Whether combining non-alcoholic fatty liver disease (NAFLD) affects the efficacy of pegylated interferon alpha (PEG-IFN-α) for patients with chronic hepatitis B (CHB) remains unknown; hence, we aimed to conduct a retrosp...Whether combining non-alcoholic fatty liver disease (NAFLD) affects the efficacy of pegylated interferon alpha (PEG-IFN-α) for patients with chronic hepatitis B (CHB) remains unknown; hence, we aimed to conduct a retrospective cohort study to investigate the impact of NAFLD on the HBsAg loss rate of CHB treated with PEG-IFN-α. A total of 279 adult CHB patients receiving antiviral therapy with PEG-IFN-α were included in the study, of which 94 (33.7%) patients had combined NAFLD. The median treatment duration in the overall population was 37 (23, 59) weeks, and 79 (28.3%) patients achieved serum HBsAg loss during treatment. Compared to patients without NAFLD, patients with NAFLD had lower baseline HBsAg levels prior to treatment with PEG-IFN-α (438.05 [152.77, 978.60] vs. 296.60 [54.20, 647.15] IU/mL, p = 0.004). Propensity score matching (PSM) was applied to rectify the baseline characteristics between the two groups, including age, gender and quantitative HBsAg level. After PSM, 84 CHB with NAFLD and 84 CHB without NAFLD were included in the matched cohort. With a comparable treatment duration in both groups, the patients with NAFLD had a lower cumulative HBsAg loss rate (Log-rank p = 0.007). Multivariable analysis suggested that NAFLD was independently associated with a decrease in HBsAg loss rates (risk ratio HR = 0.505; 95% CI, 0.283-0.902; p = 0.021), which was consistent in sensitivity analyses that included only nucleos(t)ide analogue (NA)-treated patients. In conclusion, CHB with NAFLD demonstrated a lower HBsAg loss rate during PEG-IFN-α treatment, suggesting that more optimal therapeutic strategies need to be further explored.
The degree to which alcohol use is associated with the risk of all-cause mortality and hepatic decompensation after hepatitis C (HCV) diagnosis, treatment, and cure remains unknown. We sought to address this question amo...The degree to which alcohol use is associated with the risk of all-cause mortality and hepatic decompensation after hepatitis C (HCV) diagnosis, treatment, and cure remains unknown. We sought to address this question among patients achieving sustained virologic response (SVR) after direct-acting antiviral treatment in the largest HCV health system in the United States. We extracted data on alcohol use, HCV treatment, SVR, HIV co-infection, demographics, risk behaviours, hepatic decompensation, and mortality from all patients in the 1945 to 1965 VA Birth Cohort. Alcohol use categories were generated using responses to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire and diagnostic codes for alcohol use disorder (AUD): abstinent without a history of AUD, abstinent with a history of AUD, current lower-risk consumption, current moderate-risk consumption, and current high-risk consumption with or without AUD. Cox proportional hazard models were used to examine associations between alcohol category and the risk of hepatic decompensation and all-cause mortality. Among 50,581 patients in the analytic cohort, compared to current drinkers exhibiting lower risk alcohol consumption (referent), current high-risk consumption with or without AUD was associated with increased risk of all-cause mortality (aHR: 1.40, 95% CI: 1.21-1.63) and hepatic decompensation (HR: 2.15, 95% CI: 1.60-2.89) as was abstinence with a history of AUD diagnosis (mortality aHR: 1.63, 95% CI: 1.41-1.89; hepatic decompensation aHR: 1.85, 95% CI: 1.36-2.51). AUD and high-risk alcohol consumption are associated with the risk of hepatic decompensation and all-cause mortality among Veterans who have achieved SVR, including those categorised as being currently abstinent. Interventions for alcohol consumption and use disorder among individuals treated for HCV infection may reduce morbidity and mortality in this population.
The quest for a functional cure for chronic hepatitis B (CHB) remains an elusive objective. Haematopoietic stem cell transplantation (HSCT) may elicit viral clearance by immunological remodelling in recipients with posit...The quest for a functional cure for chronic hepatitis B (CHB) remains an elusive objective. Haematopoietic stem cell transplantation (HSCT) may elicit viral clearance by immunological remodelling in recipients with positive HBsAg; however, the factors that determine its effectiveness are yet unknown. The aim of the study is to assess HSCT-induced hepatitis B surface antigen (HBsAg) seroclearance rates and identify immunological mechanisms and combination therapy strategies through meta-analysis and systematic review. In this study, nine trials (308 patients) were subjected to single-arm meta-analysis (R4.4.2 'meta' package) in accordance with PRISMA/Cochrane criteria. Heterogeneity was addressed via random-effects models (I = 87.1%). Subgroup analysis accounted for donor HBsAb/recipient HBeAg impacts. The total HBsAg clearance rate was 26% (95% CI: 14%-39%), greater than that of standard therapies. Notably, HBsAb-positive donors had significantly enhanced clearance (55% vs. 8%, p < 0.01). HBeAg-negative recipients fared better (29% vs. 2%). In patients who achieved HBsAg loss, HBsAb-positive donors and HBeAg-negative recipients are the most prevalent types (10/11). Sensitivity analyses confirmed robustness and publication bias was nonsignificant (Egger's p = 0.271). In conclusion, HSCT demonstrates the potential for functional cure in CHB, providing valuable insights into new immunological therapeutic strategies. More importantly, it serves as a powerful paradigm for identifying the immunological prerequisites for cure, informing the development of safer, targeted immunotherapies.
Baumgarten T, Lehmann F, Senff T
… +8 more, Slanina H, Schüttler CG, Walker A, Gerlich WH, Repp R, Timm J, Glebe D, Metzler M
J Viral Hepat
· 2026 Jan · PMID 41351332
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Oncology patients receiving cytostatic therapy used to be at high risk of HBV infection when HBV screening measures were less reliable. Infections acquired under these conditions often persist, like those acquired perina...Oncology patients receiving cytostatic therapy used to be at high risk of HBV infection when HBV screening measures were less reliable. Infections acquired under these conditions often persist, like those acquired perinatally or during early infancy. We studied the long-term clinical outcomes, viral characteristics, and virus-specific T-cell immunity of chronic HBV infection acquired during chemotherapy. We examined 16 chronically HBV-infected former paediatric oncology patients who were infected during cytostatic treatment in the 1980s. Patients underwent physical examination, laboratory liver function testing, non-invasive measurement of liver stiffness, and determination of HBV serology and DNA levels. If the material was sufficient, HBV sub-genotype, drug resistance and immune escape mutations, and mutations associated with HBeAg negativity were analysed. The frequency of HBV core-specific CD8+ T cells was measured after in vitro antigen-specific expansion. All but one patient were chronically infected with detectable HBsAg but were HBeAg-negative, mostly with low viraemia. Four patients were under ongoing effective antiviral therapy, and four required treatment initiation due to high viraemia or advanced liver disease. Hepatic effects were predominantly observed in highly viraemic patients. No drug resistance or immune escape mutations were observed. In two highly viraemic patients, basal core promoter and precore region mutations reducing HBeAg expression were identified. HBV core-specific CD8+ T cells were detected in all patients, but their frequency was low. In conclusion, more than 30 years after primary HBV infection was acquired during chemotherapy, the course of infection still resembles that of perinatally acquired infections.
Chronic hepatitis B virus (CHB) infection poses a serious health threat with high morbidity and mortality, influenced significantly by both innate and adaptive immune responses. The work of innate and adaptive immune sys...Chronic hepatitis B virus (CHB) infection poses a serious health threat with high morbidity and mortality, influenced significantly by both innate and adaptive immune responses. The work of innate and adaptive immune systems determines the development and prognosis of CHB. Immune checkpoints (ICs) play a crucial role in regulating the immune response by providing inhibitory or stimulatory signals when interacting with their ligands. However, the precise mechanism by which ICs affect the outcome of CHB patients remains unclear. In this study, we analysed clinical and immune data from 334 CHB patients, along with 17 healthy controls (HC). Using flow cytometry, we assessed immune cell profiles and examined the expression patterns of ICs on innate immune cells (NK/NKT) and adaptive immune cells (T cells) across different stages of CHB. Our analysis revealed distinct immune profiles and differential ICs expression among patients at various disease stages. Moreover, ICs levels were associated with immune cell functions, including cytotoxicity and antiviral cytokines production. We also found that NK and NKT cells may influence T cell function via their ICs expression. Overall, this study provides a comprehensive view of innate and adaptive immunity along with ICs variations in CHB patients, offering systematic immunological insights and suggesting ICs as a potential therapeutic target in HBV treatment.
Hepatitis A virus (HAV), traditionally a paediatric illness in endemic regions, is now exhibiting an emerging age shift in symptomatic cases. This study investigates the sero-molecular epidemiology of Hepatitis A in Pudu...Hepatitis A virus (HAV), traditionally a paediatric illness in endemic regions, is now exhibiting an emerging age shift in symptomatic cases. This study investigates the sero-molecular epidemiology of Hepatitis A in Puducherry and surrounding regions. Between January and November 2024, 513 acute viral hepatitis cases were evaluated for serum IgM anti-HAV. Representative samples underwent sequencing and B-cell epitope analysis. Of the 150 patients (29.23%) tested positive for HAV, children under 12 years (50%) were most affected, with an increasing trend in adult infection (31.33%), while adolescents aged 12-17 years accounted for 18.66%. All viral strains were genotype IIIA with no major B-cell epitope changes. A total of 732 asymptomatic individuals (2023-2024) were screened for IgG anti-HAV across different age strata (1-5, 6-10, 11-15, 16-20 and 21-30 years). The seroprevalence of HAV IgG varied by age: 1-5 years (58.5%), 6-10 years (52.87%), 11-15 years (44.95%), 16-20 years (56.88%) and 21-30 years (83.16%). Hepatitis A remains a significant health concern in Puducherry and its surrounding regions, with symptomatic infections occurring more frequently in children, followed by adults. However, HAV seroprevalence was higher in young adults and comparatively lower in children and adolescents.
Hepatitis B (HBV) prevalence is very high in pregnant women in the Dolpa district of Nepal, a region characterised by a remote geographic landscape and low vaccination coverage. Using mathematical modelling, we evaluated...Hepatitis B (HBV) prevalence is very high in pregnant women in the Dolpa district of Nepal, a region characterised by a remote geographic landscape and low vaccination coverage. Using mathematical modelling, we evaluated the impact of third-trimester tenofovir disoproxil fumarate (TDF) prophylaxis on HBV burden and estimated the time required to achieve HBV elimination in Dolpa. We developed a mathematical model to assess the impact of TDF prophylaxis on HBV elimination under four scenarios: baseline 50% vaccination coverage (scenario I), 50% TDF and baseline vaccination coverage (scenario II), 90% TDF plus baseline vaccination (scenario III) and 90% TDF and birth-dose plus 95% vaccination coverage (scenario IV). We estimated the impact TDF prophylaxis has on HBV-related morbidity and mortality and projected the time required for HBV elimination in the district. Our model suggests that HBV elimination is unlikely in Dolpa by 2100 under baseline interventions. The scale-up of TDF coverage to 90% with the baseline vaccination significantly reduces HBV prevalence and HBV-related mortality, making elimination possible in < 60 years. Implementing 90% TDF alongside birth-dose vaccination and 95% infant HBV vaccination coverage could accelerate HBV elimination-≤ 0.1% HBV prevalence in children younger than 5 years-achieving it by 2045. In geographically inaccessible settings, a micro-elimination approach using third-trimester TDF is an effective and equitable strategy for HBV control. This approach is likely to substantially reduce HBV burden and HBV-related mortality even before achieving elimination, while also addressing some of the challenges of immunoprophylaxis.