Acute hepatitis C (AHC) represents a considerable challenge to global public health, although direct-acting antiviral (DAA) therapy has substantially improved therapeutic outcomes for hepatitis C virus infection. Data we...Acute hepatitis C (AHC) represents a considerable challenge to global public health, although direct-acting antiviral (DAA) therapy has substantially improved therapeutic outcomes for hepatitis C virus infection. Data were exclusively obtained from the 2021 Global Burden of Disease (GBD) study, which examined trends in the burden of AHC in terms of incidence, mortality and disability-adjusted life years (DALYs) across 204 countries and territories globally from 2009 to 2021. In 2021, there were 7,009,910.02 incident cases, 5474.37 deaths and 266,087.98 DALYs due to AHC. Between 1990 and 2021, the number of incident cases increased by 24.61%, whereas mortality and DALYs cases decreased by 45.66% and 46.57%, respectively. The age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR) and age-standardised DALYs rate (ASDR) exhibited a declining trend. In 2021, the highest ASIRs of AHC were observed in Central Sub-Saharan Africa and Central Asia. At a national level, Mongolia and Egypt reported the highest ASIRs in 2021. The ASIR of AHC was similar in males and females, while females had higher ASMR and ASDR than males. The highest ASIR was observed in children under 5 years of age. Additionally, a negative association was found between the ASIR, ASMR, ASDR of AHC and sociodemographic index values at the regional and national levels. Our findings underscore the persistent severity of the global burden of AHC; effective and targeted strategies are needed to reduce the overall burden.
Powell AA, Costella A, Roche R
… +8 more, Leeman D, Brown A, Emmanouil B, Gillyon-Powell M, Harris R, Mitchell HD, Simmons R, Desai M
J Viral Hepat
· 2025 Apr · PMID 40135930
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The United Kingdom, along with many other countries, is working towards eliminating viral hepatitis as a public health threat by 2030, with a combined mortality target of less than or equal to six deaths per 100,000 popu...The United Kingdom, along with many other countries, is working towards eliminating viral hepatitis as a public health threat by 2030, with a combined mortality target of less than or equal to six deaths per 100,000 population. The current methodology of reporting uses death registrations alone, which has been estimated to underestimate mortality rates by up to 60% for hepatitis C (HCV)-related liver disease. We aim to conduct a sensitivity analysis using data linkage of death certificates, hepatitis B (HBV) and HCV diagnoses and admissions for end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC) to estimate mortality rates, assess progress towards elimination and evaluate underreporting. Between 2000 and 2023, 7967 deaths were reported due to HBV- and/or HCV-associated ESLD and/or HCC. Using data linkage of all three datasets, this increased to 11,487, with underreporting estimated to be 37% overall. The upper bound combined mortality rate was estimated to be 1.3 deaths per 100,000 population at its peak in 2015, therefore surpassing the WHO target for all years evaluated. From 2015 to 2023, both HCV-associated ESLD and/or HCC mortality decreased (1.12 to 0.88 deaths per 100,000 population), however, there was a slight increase for HBV-associated ESLD and/or HCC deaths during the same time frame (0.3 to 0.35). A higher proportion of HBV-related deaths were in males (p < 0.05) who died outside London (p < 0.05) and a lower proportion were White (p < 0.05) when compared to HCV-related deaths. While England has met the WHO impact targets, it is important we continue to drive reductions in mortality.
J Viral Hepat
· 2025 Apr · PMID 40116740
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The World Health Organisation has targeted the Hepatitis C virus (HCV) to be eliminated as a public health threat by 2030. Equitable access to HCV testing and treatment services is important in achieving this goal. Migra...The World Health Organisation has targeted the Hepatitis C virus (HCV) to be eliminated as a public health threat by 2030. Equitable access to HCV testing and treatment services is important in achieving this goal. Migrants often face barriers to accessing health services, and understanding HCV prevalence among this population can support planning for elimination. This systematic review aimed to estimate HCV prevalence among migrants residing in high-income countries with low/intermediate HCV prevalence. Scopus, PubMed, PsycINFO and Cochrane Library were searched for peer-reviewed articles published in English between 2015 and 2024. The studies' quality was assessed using The Joanna Briggs Institute (JBI) Critical Appraisal Tools. A proportional meta-analysis was used to estimate HCV prevalence. Thirty-seven studies were included in this review. Seventeen studies included both people < 18 and ≥ 18 years old, 16 studies only included people ≥ 18 years old, and three studies included people aged 18 and younger. The pooled prevalence of HCV antibody (anti-HCV) and RNA (HCV-RNA) were 1.5% (95% CI, 1.1%-2.0%) and 0.6% (95% CI, 0.4%-0.9%), respectively. The prevalence of anti-HCV was higher among males (1.9%) than females (0.6%). Among refugees and asylum seekers, the prevalence of anti-HCV and HCV-RNA were 1.4% and 0.7%, respectively. The prevalence of HCV among migrants is comparable with that among the general population of the destination countries. Given the barriers migrants, especially refugees and asylum seekers, face in accessing health services, their access to HCV information, testing and treatment should be facilitated.
Hardtke S, Yurdaydin C, Caruntu FA
… +13 more, Curescu MG, Yalcin K, Akarca US, Gürel S, Zeuzem S, Erhardt A, Lüth S, Papatheodoridis GV, Port K, Manns MP, Cornberg M, Kahlhöfer J, Wedemeyer H
J Viral Hepat
· 2025 Apr · PMID 40087915
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We analysed the frequency, severity and impact of hepatitis flares in a large Phase 2 study investigating pegylated interferon-alfa-2a (PEG-IFNa) for the treatment of hepatitis D. In the HIDIT-II study, 120 patients were...We analysed the frequency, severity and impact of hepatitis flares in a large Phase 2 study investigating pegylated interferon-alfa-2a (PEG-IFNa) for the treatment of hepatitis D. In the HIDIT-II study, 120 patients were treated for 96 weeks with PEG-IFNa (180 μg weekly) in combination with tenofovir disoproxil fumarate (TDF, 300 mg once daily) or placebo. Hepatitis flares were defined as ALT increases above 10 times the upper limit of normal or increases of more than 2.5-fold above baseline or nadir values. ALT flares occurred in 28 patients (23%) during treatment (< 96) and in 14 patients post-treatment until follow-up Week 24. There were no differences in the flare frequency between the two treatment arms (12 PEG-IFNa + placebo vs. 16 PEG-IFNa + TDF). The frequency of ALT increases did not differ between cirrhotic and noncirrhotic patients. None of the patients with cirrhosis experienced liver decompensation during or after a flare. Fifty-four per cent of the patients with ALT flare experienced a decrease in HDV RNA (> 1 log10 cop/ml) during subsequent study visits. Mean ALT levels early during treatment were higher in patients with HBsAg loss at follow-up Week 24. More than a third of hepatitis D patients undergoing PEG-IFNa therapy may experience ALT flares during or after treatment. ALT flares in this study posed no obvious safety risk to patients and should not lead to premature withdrawal from treatment. If ALT flares may be beneficial in single patients requires further investigation. Clinical Trial Registration: NCT00932971, EudraCT 2008-005560-13.
Oral nucleotide analogues (NAs) and peginterferon-α injections are commonly used for the treatment of patients with chronic hepatitis B (CHB). This study aims to evaluate the effects of different antiviral therapies on t...Oral nucleotide analogues (NAs) and peginterferon-α injections are commonly used for the treatment of patients with chronic hepatitis B (CHB). This study aims to evaluate the effects of different antiviral therapies on the degree of liver inflammation and fibrosis in CHB patients. This was a retrospective cohort study. A total of 101 CHB patients were admitted to the Liver Center of Xiamen Hospital of Traditional Chinese Medicine from 2017 to 2021 and were divided into three groups for different antiviral treatments: NAs therapy group (n = 36), peginterferon-α therapy group (n = 38) and nonantiviral therapy group (n = 27). The differences in degrees of liver inflammation and liver fibrosis between two histopathologic biopsies before and after treatment were analysed and compared to evaluate the efficacy of different treatments. The degrees of liver inflammation and liver fibrosis were improved after NAs or peginterferon-α therapy. In terms of improving the degree of liver inflammation, peginterferon-α therapy (74%) and NAs therapy (44%) were better than nonantiviral therapy (11%, p < 0.05), although no significant difference was shown between peginterferon-α therapy and NAs therapy (p = 0.974). For liver fibrosis improvement, peginterferon-α therapy showed significantly better efficacy than NAs therapy (68% vs. 33%, p = 0.044), while NAs therapy was better than nonantiviral therapy (33% vs. 11%, p = 0.028). Peginterferon-α and NAs can significantly improve the degree of liver inflammation and liver fibrosis in CHB patients. Peginterferon-α is superior to NAs in delaying and reversing liver fibrosis. This study provides a new basis for peginterferon-α therapy to prevent progression of fibrosis in CHB patients.
J Viral Hepat
· 2025 Apr · PMID 40087905
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Real-time polymerase chain reaction (PCR) is the current standard for serum HBV DNA measurement. However, conventional real-time PCR assays have technical limitations, and are not sensitive enough to detect low-level res...Real-time polymerase chain reaction (PCR) is the current standard for serum HBV DNA measurement. However, conventional real-time PCR assays have technical limitations, and are not sensitive enough to detect low-level residual viremia in chronic hepatitis B (CHB) patients. We developed and validated a droplet digital PCR (ddPCR) assay for high-sensitivity detection of serum HBV DNA. A ddPCR assay was developed on the QX200 ddPCR System (Bio-Rad) for detection of serum HBV DNA in 200 μL of serum. The primers and probe were designed to target a highly-conserved region in the HBV X gene. The AcroMetrix HBV Panel (Thermo Fisher Scientific) and CHB patient samples were used for validation experiments to determine the assay sensitivity, specificity, linearity, intra-run variability, and inter-run variability. The ddPCR assay demonstrated lower limit of detection of 1.6 IU/mL and lower limit of quantification of 9.4 IU/mL for serum HBV DNA in probit regression. The assay also achieved excellent specificity (96.2%), linearity (R = 0.994, R= 0.988, p < 0.001), intra-run variability (mean coefficient of variation [CV]: 0.69%, average intra-run difference: 0.026 log IU/mL), and inter-run variability (mean coefficient of variation [CV]: 4.54%, average inter-run difference: 0.18 log IU/mL). To conclude, we developed a robust ddPCR assay that achieved higher detection sensitivity with lower serum input volume than conventional real-time PCR assays. Our assay may be utilised for measuring residual viremia after nucleos(t)ide analogue therapy or for monitoring patients on novel HBV antivirals.
To investigate the effects of chronic HBV infection on the outcome of in vitro fertilisation-embryo transfer and clinical characteristics of newborns, as well as the factors influencing different outcomes of in vitro fer...To investigate the effects of chronic HBV infection on the outcome of in vitro fertilisation-embryo transfer and clinical characteristics of newborns, as well as the factors influencing different outcomes of in vitro fertilisation-embryo transfer (IVF-ET). In this study, a total of 3900 couples undergoing IVF-ET were collected and divided into four groups according to the different HBsAg carrier status of each couple, comparing the general demographic data and clinical characteristics between the four groups, analysing the differences in IVF-ET outcomes between the groups, and using multifactorial analysis of factors influencing their IVF-ET outcomes. The results showed that no significant differences (p > 0.05) were found in IVF-ET outcomes among the four groups, but multifactorial logistic regression showed that male and female age, low literacy level of men, total number of eggs acquired, LH value and P value on HCG day may affect the success rate of different IVF-ET outcomes (embryo outcome, pregnancy outcome and perinatal outcome) to different degrees. We also analysed the clinical data of 952 newborns and there were no statistically significant differences (p > 0.05) in variables including sex distribution, length, weight, health status and Apgar score. Therefore, our study suggests that neither uniparental infection nor biparental HBV infection may affect the outcome of IVF-ET or the clinical characteristics of the newborns, but the outcome of IVF-ET is affected by different factors.
Inoue J, Minami S, Abe K
… +17 more, Kida M, Haga H, Iino C, Numao H, Kuroda H, Ninomiya M, Tsuruoka M, Sato K, Onuki M, Sawahashi S, Ouchi K, Watanabe K, Akahane T, Kobayashi T, Ohira H, Ueno Y, Masamune A
J Viral Hepat
· 2025 Apr · PMID 40052685
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Chronic hepatitis B virus (HBV) infection is a leading cause of hepatocellular carcinoma (HCC) worldwide. Nucleos(t)ide analogues (NAs) are widely used in chronically HBV-infected patients, but the risk of HCC still rema...Chronic hepatitis B virus (HBV) infection is a leading cause of hepatocellular carcinoma (HCC) worldwide. Nucleos(t)ide analogues (NAs) are widely used in chronically HBV-infected patients, but the risk of HCC still remains in NA-treated patients. In this study, we aimed to validate the HCC risk scores for HBV-infected patients treated with nucleos(t)ide analogues (NAs). Among a total of 360 chronically HBV-infected patients who were treated with NAs, 253 patients without a history of HCC were used to validate the PAGE-B, mPAGE-B, PAGED-B, APA-B, and aMAP scores, as well as a recently developed score, the FAL-1 score, which consists of the FIB-4 index and ALT at 1 year of NA. In this cohort, the cumulative incidence of HCC at 5, 10, and 15 years was 2.9%, 7.8% and 11.0%, respectively. Most scores significantly stratified the HCC incidence and, for the FAL-1 score, the cumulative incidence of HCC at 10 years was 0%, 11.3% and 17.2% for the score-0 (n = 91), score-1 (n = 129) and score-2 (n = 30) groups, respectively. Compared with the other scores, the FAL-1 score was shown to efficiently identify patients at very low risk of HCC. An analysis using both this validation and the previously reported derivation cohorts demonstrated the utility in patients with either HBV genotype B or C. In conclusion, the utility of the FAL-1 score was reproduced in this validation study as well as other scores. In particular, the FAL-1 score may be useful to efficiently identify patients with a low risk of HCC.
People with mental health disorders have a significant lack of physical health care. They also have higher rates of medical co-morbidity. The aim of this study was to assess the feasibility and the linkage to care of sys...People with mental health disorders have a significant lack of physical health care. They also have higher rates of medical co-morbidity. The aim of this study was to assess the feasibility and the linkage to care of systematic screening for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in patients admitted for an acute psychiatric event at the emergency department (ED). This was an observational prospective cohort study for 1 year. Systematic screening was performed for HBV, HCV and HIV for all adult patients presenting to the ED for acute psychiatric reasons. This was a collaborative work between 3 departments (emergency, hepatology and psychiatry). A total of 584 patients were included. The median age was 42 years (range 29-56) with 304 (52%) men. Among all study patients, 50% were hospitalised in the psychiatry ward, and 38 (7%) had a positive serological screening, including 9 (2%), 19 (3%) and 12 (2%), respectively, for HBV, HCV and HIV. Among 19 patients with HCV, 12 had negative HCV RNA, 2 were treated and cured, and 5 were lost to follow-up. This study demonstrated the feasibility of HBV, HCV and HIV screening and linkage to care programmes in people with mental health disorders in the ED. The medical importance for this at-risk population confirms the significant benefit of continuing this screening in hospitals or as outpatients.
Hepatitis C virus (HCV) infection affects approximately 3.9 million people in the United States (U.S.), leading to 8000 to 10,000 deaths annually. Despite advancements in curative treatments since 2014, effective strateg...Hepatitis C virus (HCV) infection affects approximately 3.9 million people in the United States (U.S.), leading to 8000 to 10,000 deaths annually. Despite advancements in curative treatments since 2014, effective strategies targeting high-risk groups are crucial. This study examines HCV-related mortality trends from 1999 to 2020, focusing on demographic and regional disparities using the CDC WONDER database. A retrospective analysis was conducted using the CDC WONDER database. HCV-related deaths were identified using the International Classification of Diseases, Tenth Revision (ICD-10) codes B17.1 and B18.2. Mortality data were categorised by gender, age, race/ethnicity, region, place of death and urbanisation status. We calculated crude mortality rates (CRs) and age-adjusted mortality rates (AAMRs) per 100,000 population. Joinpoint regression analysis identified significant changes in mortality trends. A total of 324,008 HCV-related deaths were reported. The overall AAMR was 4.27 (95% Confidence Interval [CI]: 4.25 to 4.28). Mortality increased from 1999 to 2014 (1999 to 2007 Annual Percent Change [APC]: 5.00; 2007 to 2014 APC: 1.95) and declined sharply from 2014 to 2020 (APC: -7.11). Males exhibited higher mortality (AAMR: 6.28) than females (AAMR: 2.42). The 55-64 years age group had the highest CR (16.38), while non-Hispanic (NH) American Indians had the highest rate (AAMR: 8.72) among racial groups. Regionally, the South had the highest AAMR (5.80), nearly double that of the West (2.23) and Midwest (2.62). HCV-related mortality trends show significant demographic disparities and regional variations. Targeted interventions are essential to reduce HCV burden, particularly among vulnerable groups.
Hepatocellular carcinoma (HCC) and liver cirrhosis (LC) occur in spite of current antiviral therapies in patients with chronic hepatitis (CHB). It is not yet known why HCC and LC are related to hepatocytes and hepatic st...Hepatocellular carcinoma (HCC) and liver cirrhosis (LC) occur in spite of current antiviral therapies in patients with chronic hepatitis (CHB). It is not yet known why HCC and LC are related to hepatocytes and hepatic stellate cells (HSCs), respectively, in the same inflammation circumstances. The expression of the phosphorylated form of histone H2AX (γ-H2AX), a biomarker of DNA damage, was detected in hepatocytes and interstitial cells within the liver tissues of 69 patients with CHB using immunohistochemical assay and immunofluorescence colocalisation technique. Hydrogen peroxide (HO) was applied to establish an oxidative DNA damage model. Hepatocytes in CHB patients carried much higher levels of DNA damage than interstitial cells. The DNA damage-carried interstitial cells were confirmed to be HSCs. They lost the damaged DNA during differentiation into myofibroblasts near the foci of inflammatory necrosis. Hepatocyte was much more sensitive to oxidative stress and DNA damage than HSCs, but both MIHA and LX-2 repaired DNA damage efficiently in vitro. Hepatocytes carried much higher levels of DNA damage than HSCs due to their remarkable difference in sensitivity to inflammation-induced oxidative DNA damage. The different sensitivity may render hepatocytes and HSCs to be respectively involved in HCC and LC in the same inflammation circumstances.
Human Bocavirus (HBoV) is an emerging pathogen linked to respiratory and gastrointestinal infections in children. While its role in respiratory diseases is established, its association with liver dysfunction remains uncl...Human Bocavirus (HBoV) is an emerging pathogen linked to respiratory and gastrointestinal infections in children. While its role in respiratory diseases is established, its association with liver dysfunction remains unclear. This study presents six paediatric cases of elevated liver enzymes or acute liver failure during HBoV infection, including severe outcomes such as liver transplantation and one fatality. Frequent co-infections with other pathogens were noted, complicating the clinical course. Although direct evidence of HBoV's role in liver involvement is lacking, its potential contribution warrants further investigation to guide clinical management.
The rate of HCV infection is higher in people with psychiatric conditions than in the general population. However, access to somatic care for populations with mental or dual diagnoses remains insufficient. These circumst...The rate of HCV infection is higher in people with psychiatric conditions than in the general population. However, access to somatic care for populations with mental or dual diagnoses remains insufficient. These circumstances could constitute a barrier to the eradication of HCV infection. A retrospective study was performed in the public mental health institution of Ville Evrard. Screening for HCV infection should be systematically proposed to patients attending the institution. On-site assessment of liver disease severity and treatment with direct-acting antivirals prescribed by physicians not specialised in hepatology allowed a better continuum of care. Patients lost to follow-up after a positive HCV serology test without viral load assessment were contacted. Patients hospitalised at least once a year were included. 8520 patients out of 18,439 (46.2%) were screened for HCV infection between 2017 and 2021. The screening rate increased from 40.0% in 2017 to 65.7% in 2021. HCV seroprevalence was 2.2%. A total of 129 HCV PCRs were performed, and 27.1% were positive. In a logistic regression model, patients older than 30 years were at greater risk of having a positive HCV serology test. These positive serologies were 1.9 times higher in men than women (p < 0.001). The assessment of fibrosis was found in 45.7% of patients with a positive HCV PCR. Patients with psychiatric conditions constitute an important HCV reservoir. A strategy of screening and management of HCV infection in this population appears to be feasible. This strategy could contribute to the eradication of chronic HCV infection.
Acute-on-chronic liver failure (ACLF) is a severe clinical condition with high short-term mortality, in part due to the dysfunctional immune response. Identifying immune mechanism under ACLF is critical to understand its...Acute-on-chronic liver failure (ACLF) is a severe clinical condition with high short-term mortality, in part due to the dysfunctional immune response. Identifying immune mechanism under ACLF is critical to understand its pathogenesis and to develop novel targeted therapeutics. Among the immune cells, how are B cells involved in ACLF remains largely unknown. We performed scRNA-seq on peripheral blood mononuclear cells from clinical ACLF patients and healthy controls. Integrated analysis was performed to identify the role of B cells in ACLF. Subsequently, different subsets of B cells in ACLF were validated through flow cytometry based on their highlighted markers. Six B-cell subgroups, including naive B cells, naive B2 cells, nonclass-switched memory B cells, class-switched memory B cells, autoimmune-related B cells and plasma B cells were identified. The proportions of naive B cells significantly expand in ACLF, compared with healthy control. Function enrichment analysis revealed the activation of inflammatory response in naive B cells. Further flow cytometry confirmed the elevated circulating naive B cells in ACLF. Our study uncovered the altered immune landscape of circulating B cells after ACLF. The proportion dynamics and functional perturbation indicate the potential of naive B cells as intervention targets in the future ACLF therapy.
Published studies on tenofovir alafenamide (TAF) therapy for preventing vertical transmission of hepatitis B virus (HBV) have primarily enrolled mothers with viremic levels of approximately 7 log IU/mL. This study aimed...Published studies on tenofovir alafenamide (TAF) therapy for preventing vertical transmission of hepatitis B virus (HBV) have primarily enrolled mothers with viremic levels of approximately 7 log IU/mL. This study aimed to evaluate the efficacy and safety of TAF therapy in preventing mother-to-child transmission (MTCT) in mothers with exceptionally high viral loads, defined as HBV DNA levels > 2,000,000 IU/mL. Hepatitis B e antigen (HBeAg)-positive mothers with HBV DNA levels > 2,000,000 IU/mL were prospectively enrolled from four hospitals and initiated on TAF therapy between gestational weeks 26 and 28, continuing until delivery. All infants received immunoprophylaxis and were followed up to 28 weeks postpartum. The primary endpoints were the MTCT rate and the occurrence of congenital abnormalities in infants. Secondary outcomes included maternal HBV suppression at delivery and the safety of both mothers and infants. Among 137 mothers screened, 120 were enrolled in TAF therapy, and 121 infants completed the study. At delivery, 93.3% (112/120) of mothers achieved HBV DNA levels < 200,000 IU/mL. At birth, 0.8% (1/121) of infants had a congenital malformation, and 9.9% (12/121) tested positive for HBsAg. The vertical transmission rate was 2% (2/121, intention-to-treat) at 28 weeks of age. No severe adverse effects were reported in mothers or infants. On-treatment and postpartum alanine aminotransferase (ALT) flares after TAF cessation occurred in 7.5% (9/120) and 41.1% (46/112) of mothers, respectively, alongside viral rebound after cessation. Infant physical development remained within normal ranges based on national reference standards. In summary, approximately 2% of mothers on TAF therapy during late pregnancy experienced MTCT, despite proper immunoprophylaxis for their infants. Extending the treatment duration beyond 12 weeks for mothers with extremely high viral loads is recommended to improve MTCT prevention. No safety concerns were observed for either mothers or infants. Trial Registration: ClinicalTrials.gov identifier: NCT04237376.
Juon HS, Yang D, Fang CX
… +4 more, Hann HW, Bae H, Chang M, Klassen AC
J Viral Hepat
· 2025 Mar · PMID 39953814
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Medication nonadherence among patients with chronic hepatitis B (CHB) can lead to severe liver disease progression, including liver cirrhosis and hepatocellular carcinoma (HCC). Yet the factors that influence adherence i...Medication nonadherence among patients with chronic hepatitis B (CHB) can lead to severe liver disease progression, including liver cirrhosis and hepatocellular carcinoma (HCC). Yet the factors that influence adherence in high-risk groups, like Korean Americans, remain unclear. Thus, this study explored the psychosocial and clinical factors affecting medication adherence in CHB patients. A cohort of 365 Korean American patients with CHB from two clinics in Philadelphia and Los Angeles was studied. The 8-item Morisky Medication Adherence Scale (MMAS-8) gauged their adherence to antiviral medication. Using descriptive and multivariable logistic regression analyses, we identified factors associated with MMAS-8 scores. Of the participants, 78% were undergoing antiviral therapy, with over two-thirds (69%) reporting medium to high adherence levels. The multivariable logistic regression analysis revealed that age, knowledge of sequalae of CHB, perceived HBV stigma and possession of pharmacy plan were associated with medication adherence. Older participants had higher medication adherence than younger. High knowledge of sequalae of CHB and low perceived HBV stigma were associated with higher medication adherence. Having pharmacy plans was also associated with higher medication adherence to antiviral therapy. These findings highlight the critical role of person-related factors (e.g., knowledge and stigma) and healthcare factors in medication adherence. Future research should focus on developing targeted educational interventions focusing on personal factors to improve medication adherence among Korean American patients with CHB.
Kogias D, Gavriilidis E, Antoniadou C
… +9 more, Skeva A, Kafalis N, Tsilingiris D, Kanellis G, Panopoulou M, Mitroulis I, Ritis K, Skendros P, Kouklakis G
J Viral Hepat
· 2025 Mar · PMID 39927678
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Hepatitis E virus (HEV) infection is a frequent cause of acute viral hepatitis. Immunocompromised patients, especially those under anti-CD20 regimens, are prone to chronic or treatment-resistant courses of hepatitis E. W...Hepatitis E virus (HEV) infection is a frequent cause of acute viral hepatitis. Immunocompromised patients, especially those under anti-CD20 regimens, are prone to chronic or treatment-resistant courses of hepatitis E. We report a case of chronic HEV infection in a 36-year-old man with a history of thrombotic thrombocytopenic purpura treated with rituximab 6 months ago, who presented with new-onset painless jaundice and malaise. Laboratory tests and imaging revealed signs of inflammation and hepatic dysfunction. Due to initial suspicion of autoimmune hepatitis, corticosteroid therapy was started. However, liver biopsy and positive HEV RNA value redefined the diagnosis. Serology tests revealed initially acute infection, which later progressed to chronic hepatitis E infection. Treatment with ribavirin, along with supportive care, achieved significant clinical and laboratory improvement, resolving jaundice, restoring normal transaminase and suppressing HEV RNA values. Further review of the literature highlights the impact of immunosuppression caused by anti-CD20 therapies on HEV infection, as well as the challenges in both treatment and achieving sustained virus clearance in such patients. Moreover, this report underlines the importance of HEV screening in patients with hepatitis who have undergone anti-CD20 therapies, shedding light on a situation that is not well described in the literature and should not be overlooked, even in developed countries.
Eilard A, Ringlander J, Andersson ME
… +3 more, Nilsson S, Norkrans G, Lindh M
J Viral Hepat
· 2025 Mar · PMID 39878776
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Current guidelines to prevent hepatocellular carcinoma (HCC) by chronic hepatitis B virus (HBV) infection are based on risk assessments that include age, sex, and virological and biochemical parameters. The study aim was...Current guidelines to prevent hepatocellular carcinoma (HCC) by chronic hepatitis B virus (HBV) infection are based on risk assessments that include age, sex, and virological and biochemical parameters. The study aim was to investigate the impact of predictive markers on long-term outcomes. The clinical outcomes of 100 patients with chronic hepatitis B were investigated 30 years after a baseline assessment that included liver biopsy. A favourable outcome-HBsAg loss or HBeAg-negative infection (ENI; previously termed 'inactive carrier')-was observed in 74% of all patients, whereas 7% developed HCC. HBsAg loss was observed in 75% of patients with genotype A, compared with 42%, 33% and 0% with genotypes D, B and C, respectively (p < 0.0001). HCC developed in 3 patients (33%) with genotype C as compared with 3 (17%), 1 (2%) and 0 patients with genotypes B, D and A, respectively (p < 0.0001). In multiple logistic regression analysis, both HBsAg loss and HCC were associated with HBV genotype and baseline HBV DNA level, and HCC also with histological score. The results suggest that genotyping and histological assessment may improve outcome prediction and help decisions about HCC screening, particularly in populations with HBV-infected individuals of mixed geographic origin.
Alpha-fetoprotein (AFP) level and its changes in chronic hepatitis B (CHB) may influence the risk of future hepatocellular carcinoma (HCC). This study aims to evaluate the HCC risk in CHB patients with no overt HCC but w...Alpha-fetoprotein (AFP) level and its changes in chronic hepatitis B (CHB) may influence the risk of future hepatocellular carcinoma (HCC). This study aims to evaluate the HCC risk in CHB patients with no overt HCC but with elevated AFP level and to explore the prognostic role of longitudinal changes in AFP and liver-related laboratory values. This multicentre cohort study included 10,639 CHB patients without a history of HCC from seven medical facilities in South Korea. Patients with a baseline serum AFP test and no HCC diagnosis on imaging within 3 months were included. Patients were categorised into high-AFP (≥ 10 ng/mL) and normal-AFP (< 10 ng/mL) groups. The primary outcome was the incidence of HCC within 2 years, with secondary outcomes focused on longitudinal changes in AFP and liver-related laboratory values. Propensity score matching (PSM) and Cox proportional hazard models were used to assess HCC risk. After 1:4 PSM, 1278 high-AFP and 3731 normal-AFP patients were analysed. The high-AFP group had a significantly higher 2-year incidence of HCC (HR: 4.29; 95% CI: 3.31-5.57). AFP levels increased in patients who developed HCC in both groups (p < 0.01). Among the high-AFP group, patients who did not develop HCC had elevated baseline alanine aminotransferase levels (p < 0.01), which decreased during follow-up (p < 0.01) unlike those who developed HCC. In conclusion, baseline AFP elevation in CHB patients is associated with an increased risk of developing HCC within 2 years. Longitudinal monitoring of AFP and liver-related laboratory values can help in risk stratification.