Journal Of Viral Hepatitis[JOURNAL]
Sun
200 papers
HCV Testing and Treatment of Adults in the United States: 2014 Through 2021-Data From Two National Commercial Testing Laboratories.
Ghany MG, Ward JW, Baldwin Z … +6 more , Jiao S, Shukla N, Kuznetsova A, Kaur J, Kosch KJ, Morgan TR
J Viral Hepat · 2025 Nov · PMID 41017733 · Full text
Data on the hepatitis C virus (HCV) care cascade are crucial for determining if the United States (U.S.) is on track to meet 2016 World Health Organization elimination goals. De-identified data were analysed from persons...
Data on the hepatitis C virus (HCV) care cascade are crucial for determining if the United States (U.S.) is on track to meet 2016 World Health Organization elimination goals. De-identified data were analysed from persons who were screened for HCV antibody and/or tested for HCV RNA by two large U.S. commercial laboratories from 1/1/2014 to 12/31/2021. Validated imputation algorithms were used to identify persons who initiated treatment and who achieved virological cure based on viral load decline and continued negative HCV RNA test results. The 3-digit ZIP code was used to map treatment rates by U.S. state. During 1/1/2014 to 12/31/2021, a total of 46,646,661 persons were tested for HCV antibody of whom 2,253,500 (4.8%) were positive. Among 3,117,372 persons tested for HCV RNA, 1,951,742 (62.6%) were viremic. Cumulatively, a total of 672,745/1,951,742 (34.5%) viremic persons were treated; an estimated 643,043 (96%) were cured. Treatment rates increased with older age, higher fibrosis scores, HIV positivity, residing in an urban area and in the Northeast. Persons diagnosed by reflex testing had higher treatment rates. Comparing COVID-19 pandemic (2021) to pre-pandemic (2019) periods, 24% more HCV antibody tests were performed (10,167,524 vs. 7,727,318), but fewer persons were treated (21,136 vs. 26,124, 23% decline) and cured (19,584 vs. 24,480, 25.0% decline) in 2021, respectively. In 2021, primary care providers diagnosed and treated the greatest proportion of persons. Treatment uptake across the U.S. remains low, underscoring the need for additional measures to expand access to testing and treatment, necessary to reach the U.S. goals for HCV elimination by 2030.
Evaluation of Blood Droplet Volumes on the Cobas Plasma Separation Card for HCV RNA Testing in Resource-Limited Settings.
Qureshi H, Canchola JA, Hai G … +3 more , Latif AQ, Parkin NT, La Brot B
J Viral Hepat · 2025 Nov · PMID 41005955 · Full text
Detection of viral RNA is essential for hepatitis C virus (HCV) diagnosis. Collection and preservation of plasma, the preferred specimen type, is challenging in some areas. The Cobas Plasma Separation Card (PSC) is an al...
Detection of viral RNA is essential for hepatitis C virus (HCV) diagnosis. Collection and preservation of plasma, the preferred specimen type, is challenging in some areas. The Cobas Plasma Separation Card (PSC) is an alternative specimen type with no cold chain requirements. The PSC is designed to use capillary blood from fingerstick and capillary tube collection, but alternative sample collection options would broaden PSC utility. This study explored qualitative and quantitative HCV RNA detection with PSC prepared using a syringe needle, compared to plasma. Using a 24-gauge syringe, blood was drawn by venipuncture from HCV antibody-positive clinic patients aged > 18 years and used to prepare plasma or spotted directly onto three PSCs using 6, 8 and 10 drops per spot (group 1) or 8, 10 and 12 drops (group 2). HCV RNA was measured using the Cobas HCV assay. Test results for all conditions were available for 143 patients in group 1 and 109 patients in group 2. The proportions with detectable HCV RNA were not significantly different from plasma, and overall agreement was over 88% for any PSC spot number (Fisher exact test p > 0.1). The mean HCV viral load was lower for PSC samples vs. plasma for six or eight spots in group 1 but not statistically different for 10 or 12 spots in either group. Direct spotting of blood using a syringe is a viable alternative to finger prick and capillary tube transfer for PSC preparation. This approach may be beneficial in resource-limited settings and in patient populations for whom capillary blood collection is challenging.
Linkage to Care, Retention in Care and Treatment Uptake Among Patients Diagnosed With Chronic Hepatitis B in Norway, 2008-2022.
Salamanca BV, Johannessen A, Dalgard O … +1 more , Whittaker R
J Viral Hepat · 2025 Oct · PMID 40981422 · Full text
People living with chronic hepatitis B infection (PLWHB) need life-long care to monitor liver health and treatment need. Data on clinical follow-up for PLWHB are essential to monitor the health system response to this in...
People living with chronic hepatitis B infection (PLWHB) need life-long care to monitor liver health and treatment need. Data on clinical follow-up for PLWHB are essential to monitor the health system response to this infection. We used linked national registry data to calculate the proportion of diagnosed PLWHB in Norway linked to specialist care (LTC), treated and retained in specialist or primary care (RIC) from 2008 to 2022. We described the outcomes by time, age, sex, region of residence, place of birth and residence status. Using log-binomial regression, we explored how these factors were associated with ever being LTC and being RIC during the last 12 months of the study period. Among 10,542 diagnosed PLWHB, 8301 (79%) had ever been LTC and 2454 (23%) had received treatment. In the first 2 years after LTC, 64% were still RIC. At the end of the study period, 4476 (50%) of 8979 PLWHB still resident in Norway had been RIC in the last 12 months. PLWHB born outside Norway had a higher probability of LTC (relative risk [RR]: 1.24; 95% confidence interval [CI] 1.19-1.29) and RIC (RR: 1.67; 95% CI 1.53-1.84). Other significant associations with smaller effect sizes included a higher probability of LTC among PLWHB aged < 25 years and a lower probability of RIC when diagnosed from 2010 to 2013 or aged ≥ 65 years. The management of diagnosed PLWHB in Norway is suboptimal. Our study provides a framework for how key performance indicators can be monitored in ongoing national surveillance.
Longitudinal Profiles of Cytokines and Chemokines in Self-Limiting Hepatitis E.
Bhatia P, Mohd A, Katiyar H … +3 more , Goel A, Aggarwal R, Veerapu NS
J Viral Hepat · 2025 Oct · PMID 40960316 · Publisher ↗
Hepatitis E virus infection typically results in a self-limited acute viral hepatitis (AVH-E), which is rapidly cleared by the host immune response. In this longitudinal study, temporal cytokine and chemokine profiles we...
Hepatitis E virus infection typically results in a self-limited acute viral hepatitis (AVH-E), which is rapidly cleared by the host immune response. In this longitudinal study, temporal cytokine and chemokine profiles were analysed in AVH-E patients' sera using a multiplex immunoassay. HEV RNA became undetectable between 9 and 18 days, with a median of 13 days, occurring 3-20 days after symptom onset. In the AVH-E group, IFN-γ peaked significantly around days 6-9, which is prior to the HEV RNA clearance period, and declined during days 9-18. IL-2, IL-10, and TNF-α increased significantly during days 15-20, while IL-1β and IL-6 showed peak levels. CCL3, CXCL6, CXCL9, CXCL10 and MIF were significantly higher in the AVH-E group than in the healthy controls; CCL2 and CCL20 peaked non-significantly during days 12-17. CCL3, CXCL6, CXCL9 and CXCL10 levels were lower in the AVH-E group than in the AVH-B group. Compared to the AVH-B group and healthy controls, the AVH-E group showed distinct immune signatures. These findings highlight coordinated cytokine and chemokine responses during HEV infection and provide insights into the immunopathogenesis of self-limiting hepatitis E.
U-Shaped Relationship Between CT-Measured Liver-To-Spleen Volume Ratio and Mortality in HBV-ACLF Patients.
Yan L, Yuan M, Su M … +4 more , Cui K, Teng X, Yuan F, Bai L
J Viral Hepat · 2025 Oct · PMID 40955946 · Full text
Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition with high short-term mortality, making early prognosis crucial. The liver-to-spleen volume ratio (LSVR) provides importa...
Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition with high short-term mortality, making early prognosis crucial. The liver-to-spleen volume ratio (LSVR) provides important prognostic information but is not included in current tools. This study evaluated the link between LSVR from computed tomography and short-term mortality in HBV-ACLF patients. The study included 278 patients, divided into five groups based on LSVR quintiles. The main outcome was 28-day mortality, with a secondary focus on 90-day mortality. Multivariable Cox regression and restricted cubic splines were used to analyse the LSVR-mortality relationship. Participants had a mean age of 48 years, 82.7% were male, with 28- and 90-day mortality rates of 23.4% and 31.3%, respectively. After adjusting for covariates, the risk of 28-day mortality was elevated by 553% (OR 6.53, 95% CI 1.86-23) in the highest quintile of LSVR (Q5 ≥ 3.6) and by 343% (OR 4.43, 95% CI 1.14-17.16) in the lowest quintile (Q1 ≤ 1.6), as compared to the reference quintile (Q3 2.4-2.9). The curve-fitting results showed a U-shaped relationship between LSVR and the risk of 28-day mortality and 90-day mortality, with an infection point of 2.7. There is a U-shaped relationship between LSVR and mortality in HBV-ACLF patients. Higher or lower LSVR is associated with an increased risk of short-term mortality in HBV-ACLF patients.
Prevalence and Factors Associated With Hepatitis B Virus Infection in Tigray Region, Northern Ethiopia.
Bugssa G, Teklehaymanot T, Medhin G … +3 more , Nayagam S, Johannessen A, Berhe N
J Viral Hepat · 2025 Oct · PMID 40952341 · Publisher ↗
Hepatitis B virus (HBV) infection is a significant public health concern, particularly in low-income countries. This study investigates the prevalence and associated risk factors of HBV in Alamata district of Tigray regi...
Hepatitis B virus (HBV) infection is a significant public health concern, particularly in low-income countries. This study investigates the prevalence and associated risk factors of HBV in Alamata district of Tigray region, northern Ethiopia, where the HBV vaccine was introduced in the childhood vaccination programme in 2007. A community-based, cross-sectional study was conducted from December 2019 to June 2020. Data were collected using structured questionnaires and hepatitis B surface antigen (HBsAg) was measured using a rapid diagnostic test. Logistic regression analyses were used to determine the associations between socio-demographic, behavioural and health-related variables and HBV infection. A total of 1853 individuals (54.2% females) were included in this study. The age ranged from 5 to 88 years, and the largest age group was from 5 to 14 years (32.0%). The overall HBV prevalence was 5.3% (95% confidence interval (CI) 4.3-6.3) with significant variability between age groups: 5-14 years 3.7%, 15-24 years 6.8%, 25-34 years 10.1%, 35-44 years 4.4%, 45-54 years 3.9% and 55 years and above 3.4%. Being in the 25-34 years age group (adjusted odds ratio (AOR) 4.1, 95% CI: 1.1-16.2, P= 0.042), reporting multiple sexual partners (AOR 4.0, 95% CI: 1.02-15.4, P= 0.047) and family history of hepatitis B (AOR 3.1, 95% CI: 1.2-8.2, P= 0.024) were independently associated with HBV infection. The prevalence of HBV infection was high in this region, underscoring the necessity for targeted public health strategies aimed at reducing transmission rates. Of note, the HBV prevalence was significantly lower among children born after the introduction of the HBV vaccine.
Peer-Delivered Outreach With Rapid Treatment Pathways for Hepatitis C Testing and Treatment Among Unhoused People.
Vojt G, Bonnet P, Scott J … +8 more , Hathorn E, Ellis L, Bufton S, Mutimer D, Buchanan R, Reid L, Morris D, Elsharkawy A
J Viral Hepat · 2025 Oct · PMID 40952338 · Full text
This service evaluation describes the co-development of a peer-led rapid hepatitis C virus (HCV) pathway to reach unhoused people. A trained and qualified peer worker visited homeless shelters in West Midlands, England,...
This service evaluation describes the co-development of a peer-led rapid hepatitis C virus (HCV) pathway to reach unhoused people. A trained and qualified peer worker visited homeless shelters in West Midlands, England, setting up test and treatment events and collaborating with local services and healthcare staff who also attended the sites. The peer worker offered point of care HCV antibody and ribonucleic acid (RNA) testing for individuals at risk of HCV, peer education and support before and during treatment. Viraemic individuals were offered immediate treatment prescribed by local HCV clinical specialist nurses who attended the homeless shelters with the peer worker. Among the 140 tested individuals, 72 people (51.4%) were HCV antibody positive and 42 (30.0%) were HCV RNA positive. All participants had a history of injecting drug use. The majority were male (75.0%), with a mean age of 39 years and of white ethnicity (89.4%). Treatment uptake was 100.0%, and known treatment completion was 92.3%. Treatment uptake within 2 weeks was 57.1%. Findings suggest that the co-developed and peer-led HCV test and treat pathway is promising in case finding, testing and treating marginalised, unhoused people.
Identifying Adherence Trajectories in Chronic Hepatitis B: A Cluster-Based Approach to Long-Term Treatment Management.
Zhang L, Ji H, Pang S … +2 more , Yan Y, Zhang Z
J Viral Hepat · 2025 Oct · PMID 40944469 · Publisher ↗
This study aimed to investigate the levels and longitudinal trajectories of medication adherence among patients with chronic hepatitis B (CHB), identify key psychosocial factors influencing adherence and provide evidence...
This study aimed to investigate the levels and longitudinal trajectories of medication adherence among patients with chronic hepatitis B (CHB), identify key psychosocial factors influencing adherence and provide evidence to inform strategies for optimising long-term treatment and enhancing patients' quality of life. A longitudinal study was conducted among CHB patients, 305 completing a 12-month follow-up. Medication adherence and psychosocial data were collected at baseline and at 3, 6, 9 and 12 months. K-means cluster analysis was performed to identify distinct adherence patterns, and differences in psychosocial characteristics across clusters were analysed. Four adherence trajectories were identified: improvement, low adherence, decline and high adherence. Significant differences were observed among the groups in terms of medication adherence scores and psychosocial factors (p < 0.05). Higher adherence was positively correlated with self-efficacy and social support, while lower adherence was associated with higher levels of perceived stigma and depression. Medication adherence among CHB patients exhibits distinct dynamic patterns, strongly influenced by psychosocial factors. Targeted interventions focusing on psychological support, stigma reduction and strengthening social support networks may improve adherence and ultimately enhance the quality of life for patients with chronic hepatitis B.
Impact of Concurrent Steatotic Liver Disease and Chronic Hepatitis B on Treatment Response to Nucleos(t)ide Analogs.
Chau A, Li J, Jun DW … +52 more , Hsu YC, Toyoda H, Yeh ML, Watanabe T, Honda T, Trinh H, Nozaki A, Uojima H, Ishikawa T, Huang DQ, Vutien P, Marciano S, Abe H, Atsukawa M, Enomoto M, Takahashi H, Tsuji K, Takaguchi K, Itobayashi E, Huang R, Tsai PC, Dai CY, Huang JF, Huang CF, Yoon E, Kim SE, Ahn SB, Kim GA, Jung JH, Jeong SW, Oh H, Hsiao T, Maeda M, Tseng CH, Yasuda S, Ishigami M, Chuma M, Ito T, Kawashima K, Liu JK, Itokawa N, Kozuka R, Inoue K, Senoh T, Chuang WL, Gadano A, Tanaka Y, Lim SG, Wu C, Cheung R, Yu ML, Nguyen MH
J Viral Hepat · 2025 Oct · PMID 40944466 · Publisher ↗
Data is limited regarding response to nucleos(t)ide analogs (NA) among patients with concurrent steatotic liver disease (SLD) and chronic hepatitis B (CHB). We investigated the outcomes of NA therapy between SLD-CHB and...
Data is limited regarding response to nucleos(t)ide analogs (NA) among patients with concurrent steatotic liver disease (SLD) and chronic hepatitis B (CHB). We investigated the outcomes of NA therapy between SLD-CHB and non-SLD CHB patients in a multinational CHB cohort. Adult CHB patients treated with ETV, TDF, or TAF from 28 sites (United States, Taiwan, Japan, Korea, China, Singapore, Argentina) were retrospectively analysed. SLD was diagnosed by imaging. Propensity score matching (PSM) was used to balance the SLD-CHB and non-SLD CHB groups, and competing risks analysis was used to compare incidence and sub-distribution hazard ratios (SHRs) of VR, BR, and CR. The study included 4600 patients (26.7% with SLD). SLD-CHB patients (vs. non-SLD CHB) were younger (49.4 vs. 50.9 years, p < 0.001), more likely male (68.0% vs. 61.6%), from the West (24.9% vs. 19.3%), and with higher BMI (25.3 vs. 23.5) but less likely to have advanced fibrosis (22.6% vs. 35.9%), all p < 0.001. Following PSM, baseline characteristics became balanced between the two groups. The 5-year cumulative rates for the SLD-CHB versus non-SLD CHB groups were as follows: VR (87.9% vs. 89.8%, p = 0.16), BR (86.8% vs. 89.2%, p = 0.096), and CR (77.5% vs. 81.0%, p = 0.085). After multivariable analysis, SLD-CHB patients had a significantly lower likelihood of achieving BR (SHR = 0.77, CI: 0.68-0.88, p < 0.001) and CR (SHR = 0.84, CI: 0.72-0.97, p = 0.019), but not VR. Among CHB patients treated with NA therapy, SLD was associated with a 23% lower likelihood of biochemical response and a 16% lower likelihood of complete response but did not impact virologic response.
High Prevalence of Cirrhosis or Hepatocellular Carcinoma at Hepatitis Delta Infection Diagnosis Reflects Alarming Delays in Testing.
Wong RJ, Yang Z, Lim J … +2 more , Jou JH, Cheung R
J Viral Hepat · 2025 Oct · PMID 40944453 · Publisher ↗
Delays in timely diagnosis and treatment of hepatitis delta virus (HDV) contribute to more severe liver disease at presentation. We aim to evaluate the prevalence and predictors of advanced liver disease at presentation...
Delays in timely diagnosis and treatment of hepatitis delta virus (HDV) contribute to more severe liver disease at presentation. We aim to evaluate the prevalence and predictors of advanced liver disease at presentation among a national cohort of United States (U.S.) Veterans co-infected with chronic hepatitis B (CHB) and HDV. We retrospectively evaluated all U.S. Veterans with chronic HBV from 1/1/2010 to 12/31/2024 who underwent anti-HDV testing to evaluate the proportion who had advanced liver disease (cirrhosis, cirrhosis-related complications and hepatocellular carcinoma) at the time of HDV diagnosis. We performed sensitivity analyses among those who completed HDV RNA testing. Prevalence of advanced liver disease at the time of HDV testing was compared between anti-HDV positive and negative and among subgroups using chi-square testing. Among 29,061 chronic HBV patients, we identified 3558 patients who completed HDV testing during the study period, among whom 108 (3.0%) were anti-HDV positive and 3450 (97.0%) were anti-HDV negative. Anti-HDV positive patients had a significantly greater proportion of advanced liver disease compared to those who were anti-HDV negative (32.4% vs. 15.2%, p < 0.0001). Sensitivity analyses among patients who completed HDV RNA testing demonstrated similar trends of advanced liver disease (45.5% in HDV RNA positive vs. 18.6% in HDV RNA neg, p < 0.001). Among a national cohort of U.S. Veterans with chronic HBV, nearly 1 in 3 had already developed advanced liver disease at the time of HDV diagnosis, reflecting dangerous delays in diagnosis and treatment. Implementing effective programmes (e.g., reflex testing) to improve timely HDV diagnosis and treatment is urgently needed to prevent liver-related morbidity and mortality.
Policymaker Perspectives on the Role of Health Systems in Sustainable Hepatitis C Point-Of-Care Testing in Australia.
Conway A, Grebely J, Treloar C … +5 more , Matthews S, Lafferty L, Taylor N, Fontaine G, Marshall AD
J Viral Hepat · 2025 Oct · PMID 40939101 · Full text
Point-of-care testing for hepatitis C virus (HCV) offers multiple benefits to key populations and healthcare providers, but it has not achieved widespread implementation. This analysis investigates the impact of the heal...
Point-of-care testing for hepatitis C virus (HCV) offers multiple benefits to key populations and healthcare providers, but it has not achieved widespread implementation. This analysis investigates the impact of the health system on the sustainability of point-of-care HCV testing in Australia. Between September 2023 and January 2024, in-depth, semi-structured interviews were conducted with people involved in HCV policymaking in Australia. Data were coded using WHO's Health System Building Blocks framework (i.e., Health Workforce, Health System Financing, Medical Technologies, Leadership and Governance). Thematic analysis examined how the health system supports and hinders the long-term sustainability of HCV point-of-care testing. There were 29 participants working in seven Australian jurisdictions or nationally: 13 from departments of health, six from community-led organisations, five from local health services, and five from pathology. The analysis demonstrates the interrelations between Building Blocks, but governance was consistently foregrounded across each theme. For Health Workforce, the community approach to models of care in Australia bolstered support for HCV testing outside of traditional healthcare settings. For Health System Financing, sustainability was threatened by a lack of long-term funding mechanisms for point-of-care testing. For Leadership and Governance, state and national HCV elimination targets were seen as important to drive point-of-care testing at the local level, especially when they were reflected in services' key performance indicators. Integration into existing health system structures, sustainable funding mechanisms, and strengthened governance frameworks are needed to sustain HCV point-of-care testing in Australia. Study findings are critical to inform a long-term testing strategy in Australia and internationally.
Knowledge and Perceptions of Hepatitis B in Immigrant Populations: A Systematic Review and Thematic Synthesis of Qualitative Research.
Ahad M, Moussa D, Wallace J … +3 more , Wade AJ, Doyle JS, Howell J
J Viral Hepat · 2025 Oct · PMID 40931594 · Full text
An estimated 254 million people live with hepatitis B worldwide, with only 13% of people diagnosed and 3% receiving antiviral treatment. Without timely treatment, people with hepatitis B risk developing liver damage and...
An estimated 254 million people live with hepatitis B worldwide, with only 13% of people diagnosed and 3% receiving antiviral treatment. Without timely treatment, people with hepatitis B risk developing liver damage and liver cancer. In countries like Australia, where most people with hepatitis B are born in countries with higher prevalence, it is important that the knowledge and perceptions of hepatitis B in immigrant populations are explored to improve engagement in care. This review sought to systematically identify and synthesise qualitative research findings describing the knowledge and perceptions of hepatitis B in immigrant communities. An Ovid database search for English language publications for the years 2000-2024 was performed. 34 studies were selected for review. These were analysed using thematic synthesis and categorised using an modified version of the socio-ecological model. Ten analytic themes were identified: (1) knowledge of hepatitis B and misconceptions about transmission, (2) knowledge and familiarity with hepatitis B varies between communities, (3) culturally informed perceptions of health and illness, (4) alternative aetiologies of hepatitis B infection, (5) barriers and facilitators to engagement in healthcare, (6) sources of information, (7) stigma and family dynamics, (8) gender differences, (9) fear and anxieties of engaging with the healthcare system, (10) fear of health outcomes related to hepatitis B. These themes can be used to frame the development of culturally appropriate health promotion materials and interventions to improve knowledge and engagement in care among people living with hepatitis B.
Clinical Impact of Continuation Versus Cessation of Antiviral Therapy in Chronic Hepatitis B: A Modelling Study With Implications for Hepatitis B Cure.
Mohareb AM, Ezaz G, Kim AY … +3 more , Freedberg KA, Boyd A, Hyle EP
J Viral Hepat · 2025 Oct · PMID 40923770 · Full text
Discontinuing antivirals in chronic hepatitis B virus (HBV) 'e' antigen negative infection can enhance HBV surface antigen (HBsAg) loss but risks complications. We modelled the clinical impact of discontinuing antivirals...
Discontinuing antivirals in chronic hepatitis B virus (HBV) 'e' antigen negative infection can enhance HBV surface antigen (HBsAg) loss but risks complications. We modelled the clinical impact of discontinuing antivirals in chronic HBV. We developed a Markov state model with Monte Carlo simulation of chronic HBV to compare continuation of antiviral therapy with 3 strategies of cessation and reinitiation for: (1) virologic relapse, (2) clinical relapse, or (3) hepatitis flare. We simulated the probability of virologic relapse as an exponential decay function from the time of antiviral cessation. We used literature-based estimates for input probabilities following virologic relapse: clinical relapse (60%, conditional on virologic relapse), hepatitis flare (57%, conditional on clinical relapse) and HBsAg-loss (6%-8%). We projected HBsAg loss, cirrhosis, HCC, and survival. In 10 years, cessation strategies would increase cumulative incidence of HBsAg loss from 4.6% to 12.9%-17.3% but would not appreciably change survival (from 90.6% with continuation to 88.1%-89.0%). In an undifferentiated population, continuation would be a preferred strategy to increase average life expectancy (by 0.75-1.05 years) unless HBsAg loss following treatment cessation was > 46%. Sensitivity analyses showed that the decision to continue or stop antivirals would depend on the off-treatment rates of cirrhosis and HCC for people who remain HBsAg-positive but do not fulfil retreatment criteria. Careful selection of people for antiviral cessation using quantitative HBsAg levels could improve survival compared with continuation. Clinical practice guidelines should emphasise selective application of antiviral cessation to persons most likely to lose HBsAg without experiencing liver-related complications.
Hepatitis B Virus in Jordan: Prevalence, Incidence and Clearance From Cross-Sectional and Cohort Studies.
Abu-Dayyeh I, Chemaitelly H, Al Tibi A … +4 more , Ghunaim M, Hasan T, Abdelnour A, Abu-Raddad LJ
J Viral Hepat · 2025 Oct · PMID 40923753 · Publisher ↗
Hepatitis B virus (HBV) infection is a global health challenge, with the World Health Organization (WHO) targeting its elimination by 2030. Jordan lacks sufficient data on HBV epidemiology, including prevalence, incidenc...
Hepatitis B virus (HBV) infection is a global health challenge, with the World Health Organization (WHO) targeting its elimination by 2030. Jordan lacks sufficient data on HBV epidemiology, including prevalence, incidence and clearance. This study addresses these gaps through a retrospective analysis of HBV testing data from 40,268 individuals collected at Biolab Diagnostic Laboratories (2010-2024). Using cross-sectional and cohort study designs, the study examined hepatitis B surface antigen (HBsAg) prevalence, temporal trends, incidence, clearance rates and associated risk factors. Statistical methods included regression analyses, Kaplan-Meier estimations and Poisson models. HBsAg prevalence was 3.8% (95% CI: 3.6%-4.0%), with a nationally weighted prevalence of 5.3% (95% CI: 4.4%-6.4%). Prevalence was around 1% in individuals under 20 years, increasing to 8.5% (95% CI: 7.7%-10.0%) in the 50-59 age group. Over the past 15 years, prevalence declined by 7% annually [adjusted odds ratio (aOR): 0.93; 95% CI: 0.92-0.94]. HBsAg positivity was significantly associated with age, male sex and governorate. Cumulative HBsAg incidence was 0.26% (95% CI: 0.11%-0.64%) after 5 years of follow-up, with an incidence rate of 0.63 per 1000 person-years (95% CI: 0.26-1.51). Cumulative HBsAg clearance was 7.45% (95% CI: 4.07%-13.43%) at the 6-month follow-up mark, with a clearance rate of 17.68 per 100 person-years (95% CI: 9.51-32.86). Among HBsAg-positive individuals with > 6 months of follow-up, cumulative HBsAg clearance reached 46.12% (95% CI: 24.50%-74.34%) after 13 years of follow-up, with a clearance rate of 5.27 per 100 person-years (95% CI: 3.32-8.36). HBV epidemiology in Jordan shows declining prevalence and incidence, likely driven by expanding HBV vaccination coverage. To meet the WHO's 2030 elimination targets, Jordan must prioritise scaling up birth-dose vaccination, improving case detection and ensuring timely treatment.
Age Modifies the Association Between HBV DNA Levels and Liver Dysfunction Risk During Pregnancy.
Tao X, Yu W, Yan Q … +1 more , Han G
J Viral Hepat · 2025 Oct · PMID 40922719 · Publisher ↗
Hepatitis B virus (HBV) infection is a serious public health concern worldwide, especially during pregnancy due to the associated health risks for the mother and fetus. This study aimed to explore the relationship betwee...
Hepatitis B virus (HBV) infection is a serious public health concern worldwide, especially during pregnancy due to the associated health risks for the mother and fetus. This study aimed to explore the relationship between alanine aminotransferase (ALT) levels, age and HBV DNA levels in pregnant women with chronic HBV infection. Our cohort study included 1743 pregnant women with HBV who gave birth from January 2021 to June 2024. Participants were divided into three groups based on HBV DNA levels (log IU/mL): low (≤ 3.3; n = 691), moderate (3.3-4.3; n = 398) and high (> 4.3; n = 654). We used modified Poisson regression models and linear trend tests to assess the relationships between HBV DNA levels and gestational minimally raised alanine aminotransferase (MRALT, 40-80 U/L) or raised alanine aminotransferase (RALT, > 80 U/L). Additionally, we evaluated the associations between MRALT/RALT and obstetric outcomes. In pregnant women of advanced maternal age (≥ 35 years), HBV DNA was independently linked to a higher incident RALT risk but not to MRALT risk. A gradient was evident between HBV DNA levels and RALT risk (p for trend < 0.001). Significant links between RALT and premature birth, as well as low birth weight, were found in both participants younger than 35 years and those older than 35 years, but without statistical significance in the latter group. Age significantly modified the association between elevated HBV DNA levels and RALT risk, highlighting the importance of age-stratified monitoring in pregnant women with chronic HBV infection. This highlights the importance of targeted management to prevent adverse outcomes.
Efficacy and Safety of Velpatasvir Plus Sofosbuvir With or Without Ribavirin in Hepatitis C Patients With Decompensated Cirrhosis: A Systematic Review and Meta-Analysis.
Xiao J, Zhang X, Mao X … +3 more , Lai S, Li S, Sheng Y
J Viral Hepat · 2025 Oct · PMID 40922704 · Publisher ↗
To assess the efficacy and safety of the Velpatasvir (VEL)/Sofosbuvir (SOF) with or without Ribavirin (RBV) in treating patients with decompensated hepatitis C cirrhosis. We searched multiple databases for studies publis...
To assess the efficacy and safety of the Velpatasvir (VEL)/Sofosbuvir (SOF) with or without Ribavirin (RBV) in treating patients with decompensated hepatitis C cirrhosis. We searched multiple databases for studies published from October 2010 to September 2024. Outcomes of interest were sustained viral response at 12 weeks (SVR12) and the safety of VEL/SOF with and without RBV regimens in patients with decompensated hepatitis C virus (HCV) cirrhosis. All statistical analyses were performed using R Statistics (4.4.1). We included 13 studies that enrolled 872 adult patients with decompensated cirrhosis due to HCV. The addition of RBV to the VEL/SOF regimen neither significantly improved SVR12 after the last dose of treatment [95.0% (366/391, 95% CI: 89.0-99.0) vs. 94.0% (442/481, 95% CI: 90.0-97.0); p = 0.92] nor decreased virologic relapse [1.0% (2/158, 95% CI: 0.0-8.0) vs. 6.0% (12/197, 95% CI: 3.0-10.0); p = 0.15]. VEL/SOF plus RBV therapy had a significantly higher rate of adverse events [92.0% (261/287, 95% CI: 88.0-95.0) vs. 47.0% (167/348, 95% CI: 24.0-71.0); p < 0.01] and death [7.0% (20/287, 95% CI: 2.0-16.0) vs. 2.0% (8/366, 95% CI: 1.0-4.0); p = 0.05]. However, for patients with genotype 3, adding RBV to the VEL/SOF regimen significantly improved SVR12 [87.0% (26/30, 95% CI: 71.0-98.0) vs. 45% (7/15, 95% CI: 13.0-79.0); p < 0.01] and decreased virologic relapse [0.0% (0/10, 95% CI: 0.0-31.0) vs. 100% (1/1, 95% CI: 2.0-100.0); p = 0.02]. VEL/SOF based therapy is a safe and effective treatment for patients with decompensated cirrhosis due to HCV. The addition of RBV to VEL/SOF may increase toxicity without achieving improved efficacy overall. However, the addition of RBV significantly increased the SVR12 rate and reduced the virologic relapse in genotype 3 patients. Trial Registration: PROSPERO database: CRD42023491852.
Prescriber Specialty Involvement in Medicare Patients With Chronic Hepatitis B.
Ying X, Ng N, Reidy D … +5 more , Azari J, Rosenblatt R, Mathis WS, Congly S, Jesudian A
J Viral Hepat · 2025 Oct · PMID 40922679 · Publisher ↗
Chronic hepatitis B (CHB) is a major cause of liver-related morbidity and mortality in the United States. Patients with CHB require long-term antiviral treatment and consistent follow-up, but often face numerous barriers...
Chronic hepatitis B (CHB) is a major cause of liver-related morbidity and mortality in the United States. Patients with CHB require long-term antiviral treatment and consistent follow-up, but often face numerous barriers to accessing care and medications. In this study, we used the Medicare Part D database and the Rural-Urban Continuum code to explore specialty and geographic characteristics of healthcare providers that manage Medicare patients with CHB. Between 2013 and 2021, more than 7000 prescribers prescribed over 2.4 million 30-day prescriptions of these CHB therapies, of which 2 million (85%) were in metropolitan counties. The number of 30-day prescriptions increased by 5.4% annually. The number of prescriptions by GI increased by 12.5% a year and prescriptions by APPs increased by 12.2% a year, while prescriptions by ID decreased by 14.0% annually. In non-metropolitan counties, APPs experienced -5% APC between 2013 and 2021, and PCPs experienced -12.5% APC between 2016 and 2021. In this study, we found that there has been a noticeable shift in the specialties prescribing medications for patients with hepatitis B. Gastroenterologists and APPs became significantly more involved as prescribers. The increase in APP management of patients with CHB is a welcoming development, especially in light of the physician workforce shortage. It is important to create solutions such as co-management to ensure that patients with CHB receive consistent care without further contributing to supply-demand mismatch in gastroenterology.
Reduced Predictive Performance of the FIB-4 Index in Chronic Hepatitis B Patients With Concurrent Metabolic Dysfunction-Associated Liver Disease.
Natour RT, Haimi M, Hazan R … +2 more , Saadi T, Baker FA
J Viral Hepat · 2025 Oct · PMID 40919904 · Full text
The coexistence of chronic hepatitis B (CHB) and metabolic dysfunction-associated liver disease (MASLD) gained recognition, but the diagnostic performance of non-invasive markers regarding it remains underexplored. This...
The coexistence of chronic hepatitis B (CHB) and metabolic dysfunction-associated liver disease (MASLD) gained recognition, but the diagnostic performance of non-invasive markers regarding it remains underexplored. This study aimed to evaluate the utility of the FIB-4 index for fibrosis prediction in CHB patients and investigate its performance in the distinct subgroup of CHB-MASLD. A prospective study from 2021 to 2022 included 109 CHB and 64 CHB-MASLD patients. All underwent liver stiffness measurement via elastography and FIB-4 calculation. MASLD criteria were defined, creating CHB-alone and CHB-MASLD groups. FIB-4 values were compared to the liver stiffness measurements. Statistical analyses included t-tests, ROC curves, and correlation assessments. No significant age, gender, or ethnicity differences were observed between the CHB and CHB-MASLD groups. CHB-MASLD patients exhibited higher BMI, dysglycemia, and dyslipidemia. HBeAg negativity and nucleoside/tide treatment rates were comparable. FIB-4 and APRI scores were elevated in CHB-MASLD. ROC analysis revealed an AUC of 0.86 for FIB-4 in the CHB group, with an optimal cutoff of 1.95. Subgroup analysis by BMI showed consistent FIB-4 performance. In the CHB-MASLD group, the ROC curve showed an AUC of 0.61 (p = 0.12), indicating non-significance. Our study affirms FIB-4's robust performance in predicting fibrosis in CHB patients across varied BMI profiles. Yet, challenges surface when applying FIB-4 to those with concurrent CHB and MASLD. These limitations stress the urgency of refined fibrosis prediction tools, essential for navigating the complex interplay of viral and metabolic factors in the CHB-MASLD population.
Protective Role of Coffee in Chronic Liver Disease: A Focus on Processing.
Khalifa R, Al-Naamani K, Elbadry M … +3 more , Zhang YY, Alswat K, El-Kassas M
J Viral Hepat · 2025 Oct · PMID 40919888 · Publisher ↗
Chronic liver disease (CLD) is a leading cause of global morbidity and mortality, necessitating effective preventive strategies. Growing evidence is linking coffee consumption with reduced risk of disease progression in...
Chronic liver disease (CLD) is a leading cause of global morbidity and mortality, necessitating effective preventive strategies. Growing evidence is linking coffee consumption with reduced risk of disease progression in various CLDs, including metabolic dysfunction associated steatotic liver disease (MASLD), alcoholic liver disease, hepatitis B and C, autoimmune hepatitis, and a reduction in the risk of hepatocellular carcinoma development. Coffee, a globally consumed beverage, contains bioactive compounds like caffeine, chlorogenic acids, diterpenes, and polyphenols, which may offer hepatoprotective benefits through anti-inflammatory, antioxidant, and metabolic regulatory effects. This narrative review discusses the current evidence demonstrating an inverse correlation between regular coffee intake and CLD progression, highlighting dose-dependent benefits with optimal consumption at three to four cups per day. Potential mechanisms for hepatoprotective effects of coffee involve modulation of the gut-liver axis, epigenetic regulation, and improving liver transaminitis. Additionally, the current review explores the effects of different coffee processing methods, such as roasting levels and brewing techniques, on these protective properties. Coffee's role as an affordable, culturally accepted intervention to mitigate the burden of CLD offers a compelling avenue for future public health strategies. Despite promising evidence, there is a need for further proof to establish the most beneficial coffee preparation methods.
Trends in Use of Direct-Acting Antivirals for Treatment of Hepatitis C Virus Infection in Australia 2016-2024.
Luong CL, Ellett LK, Pratt N … +2 more , Staff K, Janetzki J
J Viral Hepat · 2025 Oct · PMID 40913403 · Full text
Direct-acting antivirals (DAAs) have transformed hepatitis C virus (HCV) treatment in Australia since their inclusion on the Pharmaceutical Benefits Scheme (PBS) in 2016. Treatment has shifted from genotype-specific to p...
Direct-acting antivirals (DAAs) have transformed hepatitis C virus (HCV) treatment in Australia since their inclusion on the Pharmaceutical Benefits Scheme (PBS) in 2016. Treatment has shifted from genotype-specific to pan-genotypic regimens, with glecaprevir/pibrentasvir and sofosbuvir/velpatasvir now recommended in clinical guidelines. This study examined trends in DAA dispensing in light of evolving treatment regimens. A retrospective analysis of publicly available PBS data was conducted, assessing monthly DAA dispensings from March 2016 to December 2024. Dispensings were summarised by count and proportion, PBS item code, schedule (general, private, or public hospital) and number of repeats as a proxy for treatment duration. Dispensing volumes of DAAs increased following PBS-listing in March 2016, with the highest number of dispensings observed between 2016 and 2017 (average of 11,378 prescriptions dispensed per month). Dispensing rates subsequently declined, with an average of 1583 prescriptions dispensed per month from 2020 to 2024. Since introduction to market in August 2017, sofosbuvir with velpatasvir (pan-genotypic regimen) has maintained an average market share of 55%. Glecaprevir/pibrentasvir (pan-genotypic regimen) has maintained an average market share of 34% since its introduction in August 2018. Sofosbuvir/velpatasvir/voxilaprevir, listed on the PBS in April 2019, and used for salvage therapy, has had a smaller average market share of 4% since listing. Pan-genotypic regimens now account for nearly all DAA use in Australia. Declining dispensing rates may reflect reduced new infections and treatment fatigue. Increasing retreatment rates underscore the need for ongoing monitoring and real-world evaluations. Future head-to-head comparisons may support optimal regimen selection.
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