Journal of Viral Hepatitis最新文献

{"title":"M1-Like Macrophage May Contribute to the Inflammation and Fibrosis Process of Chronic Hepatitis B","authors":"Yuxue Gao,&nbsp;Pengxiang Yang,&nbsp;Yuanyue Guan,&nbsp;Pengxiang Liu,&nbsp;Dexi Chen,&nbsp;Qiqi Ning","doi":"10.1111/jvh.70052","DOIUrl":"https://doi.org/10.1111/jvh.70052","url":null,"abstract":"<div>\u0000 \u0000 <p>Chronic hepatitis B (CHB), driven by persistent hepatitis B virus (HBV) infection, is characterised by unresolved liver inflammation and fibrosis. Despite its clinical burden, the immune mechanisms underpinning CHB progression, particularly the role of macrophage polarisation, remain incompletely defined. We integrated multi-modal approaches to dissect the CHB immune microenvironment: immunohistochemistry (HBsAg/HBcAg quantification), imaging mass cytometry (spatial immune mapping), microfluidic high-throughput qPCR (gene profiling) and MILLIPLEX assays (cytokine quantification). In vitro, HBV-producing HepG2.2.15 cells were cocultured with polarised THP-1 macrophages (M1/M2) and LX-2 hepatic stellate cells (HSCs) to model macrophage–HSCs crosstalk. CHB severity correlated with elevated virologic markers (HBsAg, HBeAg, HBV DNA) and liver injury indices (ALT/AST). The hepatic immune landscape was dominated by M1-like macrophages, which colocalised with activated HSCs and collagenⅠ+ fibrotic niches. Intrahepatic M1 markers (CD86, TNFα, CXCL9 and CXCR3) were upregulated, while the M2 marker IL-10 was suppressed. Serum HBeAg levels positively correlated with intrahepatic CD86 and CXCL9, implicating HBeAg as a key driver of M1 polarisation. Compartment-specific cytokine profiling revealed elevated liver-to-plasma ratios of TGF-α, IFN-γ and IP-10 in advanced CHB, contrasting with reduced IL-10. In vitro, HBV skewed THP-1 macrophages towards an M1 phenotype and HBV-primed M1 macrophages potently activated LX-2 cells. Persistent HBV infection fuels CHB progression by fostering a pro-inflammatory M1 macrophage-dominated microenvironment, which synergises with HSCs activation and fibrogenesis. Our findings nominate M1 polarisation as therapeutic targets to disrupt inflammation–fibrosis crosstalk in CHB.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, Regional and National Burden of Chronic Hepatitis C, 1990–2021: A Systematic Analysis for the GBD Study 2021","authors":"Yuan Li,&nbsp;Zhiyan Li,&nbsp;Rong Chen,&nbsp;Cuijun Jia,&nbsp;Haitao Liu,&nbsp;Maomao Tang,&nbsp;Su Zhou,&nbsp;Daiyan Fu,&nbsp;Xiaoli Tang,&nbsp;Lu Chen,&nbsp;Dan Pan,&nbsp;Lei Wang,&nbsp;Fang Wen,&nbsp;Tian Luo,&nbsp;Liheng He","doi":"10.1111/jvh.70053","DOIUrl":"https://doi.org/10.1111/jvh.70053","url":null,"abstract":"<div>\u0000 \u0000 <p>Chronic hepatitis C (CHC) remains a major global health burden, disproportionately affecting low-resource regions. Despite direct-acting antiviral (DAA) advancements, persistent liver complications and socioeconomic disparities hinder progress. This study aims to analyse CHC burden trends (1990–2021) across sociodemographic index (SDI), age, gender and geography using Global Burden of Disease (GBD) 2021 data. Data on incidence, death, prevalence and disability-adjusted life years (DALYs) were extracted from the Global Health Data Exchange (GHDx) platform, and countries were stratified by SDI. To analyse the trend in the disease burden of CHC, we utilised R software to compute the estimated annual percentage change (EAPC). Based on our investigation, we discovered that global incident cases rose 20.4% (3.7–4.5 M), yet age-standardised incidence rate (ASIR) declined annually by 0.55%. Globally, there has been a decreasing trend in the age-standardised mortality rate, prevalence and DALYs associated with CHC. Furthermore, women have shown a more significant decrease in incidence and mortality compared to men. New cases in those over 70 increased significantly, driven by population growth, particularly in low-SDI countries. These findings indicate that CHC burden remains concentrated in low-SDI regions and ageing populations. Persistent gender and socioeconomic inequities demand equitable DAA access, ageing-focused care and gender-sensitive interventions to achieve elimination targets.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult Hepatitis C Virus Infection: A Narrative Review","authors":"Busara Songtanin,&nbsp;Jackeline Flores,&nbsp;Romelia Barba,&nbsp;Jowana Saba,&nbsp;Kenneth Nugent","doi":"10.1111/jvh.70051","DOIUrl":"https://doi.org/10.1111/jvh.70051","url":null,"abstract":"<div>\u0000 \u0000 <p>Hepatitis C virus (HCV) infections occur worldwide. Approximately 75% of these acute infections lead to chronic hepatitis C with few symptoms, at least during the initial phase of infection. Occult hepatitis C develops in some infected patients. These infections are defined by the presence of HCV RNA in hepatocytes and peripheral blood mononuclear cells (PBMCs) but not in the serum. Some of these patients have negative tests for anti-HCV antibodies, which make them very difficult to detect. These patients have been identified throughout the world. Occult infections have been found more frequently in patients with hepatitis B infection, HIV infection, cryptogenic liver disease/cirrhosis, renal failure on haemodialysis and lymphoproliferative disorders. These infections have also been identified in blood donors who have negative HCV antibodies. Low-level viral replication in the liver likely contributes to ongoing liver damage and the release of infectious virions that potentially infect adjacent hepatocytes and extrahepatic sites, such as PBMCs. Studies indicate that occult HCV infection may contribute to the pathogenesis of cryptogenic liver disease, steatotic liver disease, cirrhosis and hepatocellular carcinoma and could cause relapses following either a spontaneous clearance of the virus or treatment-induced clearance of the virus. These infections present diagnostic difficulties. This virus is present in the liver; however, that would require a liver biopsy to demonstrate this. It is also present in PBMCs, but these cells are not usually used during routine patient evaluation. The development of quasispecies, which can be identified in PBMCs by specialised labs, helps explain ineffective host defence responses and antiviral drug treatment in some patients. There is no specific therapy for the treatment of this sub-group of HCV-infected patients, and treatment should start with direct-acting antiviral drugs with careful follow-up and serial testing for viral clearance. In summary, patients with occult HCV need more study to determine the role of these infections in the progression of liver disease, to improve diagnostic algorithms and to determine treatment protocols that can eliminate these low-level infections.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Efficiency and Accuracy in Hepatitis C Rapid Antibody Testing: Insights From a Cluster Randomised Crossover Trial","authors":"K. Heath,&nbsp;R. Guzman,&nbsp;I. Elsum,&nbsp;A. J. Wade,&nbsp;K. Allardice,&nbsp;J. Kasza,&nbsp;M. Bryant,&nbsp;A. J. Thompson,&nbsp;M. Stoové,&nbsp;T. Snelling,&nbsp;N. Scott,&nbsp;T. Spelman,&nbsp;D. A. Anderson,&nbsp;J. Richmond,&nbsp;J. Howell,&nbsp;N. Andric,&nbsp;P. Dietze,&nbsp;P. Higgs,&nbsp;R. Sacks-Davis,&nbsp;A. Forbes,&nbsp;M. E. Hellard,&nbsp;A. E. Pedrana,&nbsp;J. S. Doyle","doi":"10.1111/jvh.70043","DOIUrl":"https://doi.org/10.1111/jvh.70043","url":null,"abstract":"<p>Hepatitis C remains a significant global health problem, particularly among people who inject drugs. To achieve Australia's 2030 elimination targets, efficient testing strategies are needed. The OraQuick rapid antibody test provides results in 20 min, but many non-viraemic individuals with resolved infections test positive, potentially leading to unnecessary confirmatory RNA testing. Reducing the read time to five minutes has been proposed to reduce false positives and improve efficiency, but its impact on viremia detection is unclear. This study utilised data from the QuickStart study, a randomised controlled trial investigating different rapid testing pathways and a same-day test-and-treat model. Participants underwent OraQuick rapid antibody testing with results read at both five and 20 min, followed by confirmatory RNA testing. Among 298 participants with OraQuick and RNA test results, the 20-min OraQuick test was positive for all 79 viraemic individuals and 156 non-viraemic individuals. At five minutes, positive results decreased to 77 (97.5%) of viraemic and 135 (87%) non-viraemic individuals with positive 20-min results. Using a five-minute result to trigger RNA testing would have reduced unnecessary RNA testing by 13% in our cohort at the cost of missing 2.5% of viraemic individuals. A five-minute read time could improve efficiency by reducing unnecessary RNA testing, but confirmatory RNA testing remains essential to distinguish active from resolved infections. The balance between efficiency and accuracy may vary contextually, reflecting differing rates of resolved infections. This approach may be beneficial in resource-limited settings, but the potential for missed viremia must be considered.</p><p><b>Trial Registration:</b> ClinicalTrials.gov number; NCT05016609</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognisable Alcohol Use Significantly Increases the Risk of Adverse Outcomes in Patients With Hepatitis B Virus-Related Cirrhosis","authors":"Vicki Wing-Ki Hui,&nbsp;Zeyuan Yang,&nbsp;Terry Cheuk-Fung Yip,&nbsp;Ramsey Cheung,&nbsp;Jimmy Che-To Lai,&nbsp;Vincent Wai-Sun Wong,&nbsp;Grace Lai-Hung Wong,&nbsp;Robert John Wong","doi":"10.1111/jvh.70049","DOIUrl":"https://doi.org/10.1111/jvh.70049","url":null,"abstract":"<div>\u0000 \u0000 <p>Chronic hepatitis B virus (HBV) infection is a major contributor to cirrhosis, hepatic events and mortality, even when antiviral treatments are used. However, alcohol consumption may compromise these benefits. This study evaluated the impact of alcohol use on outcomes in patients with HBV-related cirrhosis. Patients initiating first-line antiviral therapy between 2017 and 2023 were classified as alcohol users (including social drinkers, ex-drinkers or those with alcohol use disorders) or non-drinkers, with further differentiation between heavy and mild drinkers. A Fine-Grey model was used to adjust for the competing risks of non-liver–related death and liver transplantation, and propensity score matching and weighting balanced baseline characteristics. Among 12,317 patients (mean age 65 years, 77% male), 31% were alcohol users, of whom 32% were heavy drinkers. In propensity score–matched analyses, non-drinkers exhibited better transplant-free survival and lower liver-related mortality than drinkers. Overall, alcohol use was associated with a 20%–30% increased risk of all-cause mortality or liver transplantation, as well as liver-related death, with heavy alcohol consumption conferring even greater risk. These findings underscore the need for systematic screening for alcohol consumption and the implementation of interventions aimed at reducing alcohol use in patients with HBV-related cirrhosis.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis C Patients Over the Age of 75 Should Be Treated With Direct-Acting Antivirals, as Their Prognosis With Treatment Is Similar to That of Uninfected Healthy Individuals of the Same Age","authors":"Shintaro Takaki,&nbsp;Kazuki Ohya,&nbsp;Nami Mori,&nbsp;Hidenori Ochi,&nbsp;Keiji Tsuji","doi":"10.1111/jvh.70048","DOIUrl":"https://doi.org/10.1111/jvh.70048","url":null,"abstract":"<div>\u0000 \u0000 <p>Recently, the incidence of hepatitis C virus (HCV) in older individuals has increased. Although direct-acting antivirals (DAAs) are widely used to treat HCV without side effects in older patients, their indications are uncertain. This study compared the survival outcomes of older patients with HCV who received DAAs and age-matched peers without HCV infection. We enrolled 218 patients with HCV aged over 75 years treated with DAA (DAA group) and 519 HCV antibody-negative individuals (control group) who underwent physical examination and follow-up at our institute between January 2015 and December 2023. The cumulative survival rate after initial examination, cause of death, and hepatocellular carcinoma (HCC) occurrence were compared between DAA-treated patients with or without a prior HCC history and the control group. All patients treated with DAAs achieved a sustained virologic response. The prognosis of the overall DAA cohort was worse compared to the control group (<i>p</i> &lt; 0.001); no significant difference emerged upon limiting the comparison to the subgroup without a prior HCC history (<i>p</i> = 0.280), while the prognosis was significantly worse in the DAA subgroup with a prior HCC history. Propensity-score matched analysis revealed similar results (<i>p</i> = 0.191). The causes of death did not differ between the DAA subgroup without prior HCC and the control group. DAA eliminates HCV in patients aged over 75 years, and offers a prognosis equivalent to that of HCV-negative healthy individuals of the same age, especially in patients without a prior HCC history.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Assisted Reproductive Technology in Women With Hepatitis B Infection","authors":"Xiaoling Hu,&nbsp;Shan Wan,&nbsp;Huanmiao Yan,&nbsp;Minyue Tang,&nbsp;Guofang Feng,&nbsp;Aixia Liu,&nbsp;Yimin Zhu","doi":"10.1111/jvh.70047","DOIUrl":"https://doi.org/10.1111/jvh.70047","url":null,"abstract":"<div>\u0000 \u0000 <p>Hepatitis B virus (HBV) infection remains a global public health problem. To investigate whether HBV infection in women with different serostatus affects the outcomes of assisted reproductive technology (ART). This study included a total of 9891 infertile couples, comprising 1670 couples with HBV-infected women and 8221 couples without HBV infection, all undergoing ART treatments during the same period. None of the male partners had chronic HBV infection. Three groups were defined: HBV-positive, HBeAg/preS1-positive and HBV-negative groups. Pregnancy outcomes were evaluated and compared using multivariate logistic regression analysis to control for confounding factors. Decreased rates of implantation, clinical pregnancy and live birth were observed in women with HBeAg/preS1-seropositive status. Following multivariate adjustment for potential confounders, the live birth and clinical pregnancy rates in the HBeAg/preS1-positive group were still significantly lower than those in the HBV-negative group, with adjusted odds ratios of 0.86 (95% CI, 0.75–0.99) and 0.84 (95% CI, 0.73–0.96), respectively. No significant difference was observed between the HBV-positive and HBV-negative groups. Additionally, no differences were found in the miscarriage rate or preterm rate among the three groups. Women who were HBsAg- or HBeAg/preS1-seropositive exhibited a significantly higher incidence of secondary and tubal factor infertility compared to those without HBV infection. Overall HBV infection in women increases the risk of secondary infertility and tubal factor infertility, and female HBeAg/preS1-seropositive status adversely affects live birth and clinical pregnancy outcomes. The effect is likely attributed to the active HBV infection.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Sustainability of an Implementation Intervention (FOCUS Program) on Linkage to Hepatitis C Care Time at a Community Health Center in the Deep South: A Longitudinal Study Based on Electronic Medical Records","authors":"Adelero Adebajo,&nbsp;Shan Qiao,&nbsp;Irene Esu,&nbsp;Bankole Olatosi,&nbsp;Xiaoming Li","doi":"10.1111/jvh.70045","DOIUrl":"https://doi.org/10.1111/jvh.70045","url":null,"abstract":"<p>People with hepatitis C should be identified and promptly linked to care after diagnosis to eliminate hepatitis C virus (HCV) infection by 2030. An implementation intervention, an HCV screening and linkage to care intervention, the FOCUS program, highlighted by four pillars (normalisation of routine testing, promotion of testing based on electronic medical records [EMR], procedure overseen by linkage coordinator, and quality improvement training/feedback among staff), has been conducted in a community health center in South Carolina from 2018 to 2020. We aim to assess the impacts of this intervention on linkage to care time and its sustainability. We analysed a cohort (<i>n</i> = 593) of adults who tested positive for hepatitis C infection, all of whom received hepatitis C care services from the Cooperative Health Center (January 2015 to March 2023) from the EMR data. Descriptive analysis was employed for outcome (linkage to care days [LTC days]) and sociodemographic variables (i.e., race, sex, age, health insurance). We compared the sociodemographic and average LTC days among pre-intervention (2015–2017), during-intervention (2018–2020), and post-intervention (2021–2023) phases. Multivariate linear regressions were conducted on LTC days and intervention phases, controlling for relevant covariates. Most (59.5%) of the participants were 45 to 64 years of age. Sixty percent were males, and 57% were African Americans. Around 45% of the participants did not have health insurance. The mean LTC days at pre-intervention were 66.68 (SD = 72.29). LTC days reduced by 31 days during the intervention compared to pre-intervention (<i>ß</i> = −31.21, <i>p</i> &lt; 0.001). Similarly, in the post-intervention phase, LTC days reduced by 30 days compared to pre-intervention (<i>ß</i> = −29.96, <i>p</i> &lt; 0.001). Age was associated with LTC days, with middle-aged people (45–64 years) having the longest LTC days. Our study suggests that the intervention had a robust immediate effect, which was maintained in the post-intervention period, thus highlighting its lasting impact. Since its implementation, the FOCUS program has significantly shortened the days of linkage to care for people with hepatitis C. We noted the positive impacts across the different demographics studied. More importantly, the impacts were sustainable through the COVID-19 pandemic. We need future efforts to engage middle-aged groups to further reduce the hepatitis C LTC days.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Term Clinical Outcomes in Chronic Hepatitis C Patients Who Achieved SVR Following DAAs: A Decade Long Prospective Study","authors":"Gamal Shiha,&nbsp;Ahmed Helmy,&nbsp;Nabiel Mikhail,&nbsp;Ayman Hassan,&nbsp;Heidi Elkerdawy,&nbsp;Ghada Badawy,&nbsp;Hanzada El Maghrabi,&nbsp;Nada El-Domiaty,&nbsp;Riham Soliman","doi":"10.1111/jvh.70044","DOIUrl":"https://doi.org/10.1111/jvh.70044","url":null,"abstract":"<div>\u0000 \u0000 <p>The long-term impact of direct-acting antivirals (DAAs) in chronic hepatitis C virus (HCV) patients remains debated. This study evaluates all-cause mortality, hepatocellular carcinoma (HCC), and decompensated cirrhosis in DAAs-treated patients enrolled in the ‘Educate, Test, and Treat’ programme. This prospective observational study included HCV patients treated at the Egyptian Liver Research Institute and Hospital (ELRIAH) from 2015 to 2018. Participants were recruited from 12 villages and followed until the end of 2024. Exclusions included decompensated liver disease, hepatitis B virus (HBV)/human immunodeficiency virus (HIV) co-infection, prior HCC, or severe comorbidities. Follow-up included clinical, biochemical, ultrasound, and liver stiffness measurements (LSM). Primary outcomes were all-cause mortality, HCC, and decompensated cirrhosis. Kaplan–Meier curves and Cox models analyse data. Of 3328 eligible patients, follow-up data were available for 3017 (53% male, mean follow-up: 84.5 ± 28.9 months). Advanced fibrosis (F3–F4) was present in 1125 (37.3%). The study recorded 593 deaths (2.58/100 person-years), 271 HCC cases (1.24/100 person-years), and 281 decompensated cirrhosis cases (1.30/100 person-years). Advanced fibrosis was associated with increased mortality (HR: 1.72, 95% CI: 1.46–2.03, <i>p</i> &lt; 0.001) and decompensation (HR: 2.23, 95% CI: 1.74–2.85, <i>p</i> &lt; 0.001) but not HCC (HR: 1.17, 95% CI: 0.92–1.49, <i>p</i> = 0.192). Fibrosis reversed in 11.9%, improved in 17.8%, remained stable in 50.5%, and progressed in 19.8%. This decade-long study confirms DAAs improve liver function, reduce mortality, and slow disease progression, reinforcing their role in preventing long-term complications.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Universal Screening for HDV in HBV-Infected Patients on Chronic HDV Detection Rate in Israel","authors":"David Yardeni,&nbsp;Omer Cividalli,&nbsp;Bryan Itkowitz,&nbsp;Inna Lipnizkiy,&nbsp;Ali Abu Juma'a,&nbsp;Naim Abufreha,&nbsp;Ayelet Keren-Naus,&nbsp;Nadav Eisner,&nbsp;Anat Nevo Shor,&nbsp;Ohad Etzion","doi":"10.1111/jvh.70046","DOIUrl":"https://doi.org/10.1111/jvh.70046","url":null,"abstract":"<p>Hepatitis delta virus (HDV) and hepatitis B virus (HBV) co-infection is considered a progressive chronic viral hepatitis where treatment options are limited and significant morbidity and mortality are prevalent. Studies have shown insufficient testing for HDV antibody (anti-HDV) among HBV-infected patients. Unlike European and Asian-Pacific guidelines, the American Association for the Study of Liver Diseases (AASLD) guidelines recommend HDV testing only for high-risk HBV patients. We evaluated the efficacy of universal vs. risk-based screening in identifying HDV infection among HBV patients. We performed a retrospective analysis of patients diagnosed with a positive HBsAg in a tertiary medical center and screened for HDV between 2010 and 2022. 761 patients were found to be HBsAg-positive. 525 (69%) patients met AASLD criteria for HDV screening (high-risk) and 236 (31%) did not (low-risk). Universal screening was performed on 559 (73.4%) patients. In the high-risk group, anti-HDV positivity was found in 33 patients (8.6%). 17 (51.5%) were found to be HDV RNA-positive. In the low-risk group, 4 (2.3%) were found to be anti-HDV-positive. None were found to be HDV RNA-positive. Screening based on AASLD criteria identified only 89% of HDV antibody-positive patients. During the study period, an increased rate of all-cause mortality was observed in the AASLD high-risk group. In this single-center study, universal screening of HBsAg-positive patients identified 11% more anti-HDV-positive patients in comparison to the AASLD-supported high-risk-only screening recommendations. Due to the paramount importance of HDV detection, universal HDV screening in HBsAg-positive patients is encouraged.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}