Journal of Viral Hepatitis最新文献

{"title":"The complex, confusing and poorly understood immune responses to AAV-mediated gene transfer in haemophilia—Is more or less immunosuppression required?","authors":"Edward G. D. Tuddenham,&nbsp;Graham R. Foster","doi":"10.1111/jvh.13934","DOIUrl":"https://doi.org/10.1111/jvh.13934","url":null,"abstract":"<p>Attempts to achieve a functional cure or amelioration of the severe X linked bleeding disorders haemophilia A (factor VIII deficiency) and haemophilia B (factor IX deficiency) using AAV-based vectors have been frustrated by immune responses that limit efficacy and durability. The immune responses include adaptive and innate pathways as well as cytokine mediated inflammation, especially of the target organ cells—hepatocytes. Immune suppression has only been partly effective in clinical trials at ameliorating the immune response and the lack of good animal models has delayed progress in identifying mechanisms and developing more effective approaches to controlling these effects of AAV gene transfer. Here we discuss the arguments for and against more potent immunosuppression to improve factor expression after AAV-mediated gene therapy.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.13934","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140546824","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":"Antiviral therapy response in patients with chronic hepatitis B and fatty liver: A systematic review and meta-analysis","authors":"Fajuan Rui,&nbsp;Elizabeth Garcia,&nbsp;Xinyu Hu,&nbsp;Wenjing Ni,&nbsp;Qi Xue,&nbsp;Yayun Xu,&nbsp;Xiaoming Xu,&nbsp;Junping Shi,&nbsp;Mindie H. Nguyen,&nbsp;Ramsey C. Cheung,&nbsp;Jie Li","doi":"10.1111/jvh.13942","DOIUrl":"10.1111/jvh.13942","url":null,"abstract":"<p>The impact of concurrent fatty liver (FL) on response to antiviral therapy in chronic hepatitis B (CHB) patients has not been well characterized. We aimed to systematically review and analyse antiviral treatment response in CHB patients with and without FL. We searched PubMed, Embase, Web of Science and the Cochrane Library databases from inception to 31 May 2023 for relevant studies. Biochemical response (BR), complete viral suppression (CVS) and hepatitis B e antigen (HBeAg) seroconversion in CHB patients with FL (CHB-FL) and without FL (non-FL CHB) were compared. In an initial pool of 2101 citations, a total of 10 studies involving 2108 patients were included. After 12 weeks of treatment, CHB-FL patients as compared with non-FL CHB patients had lower BR rate (48.37% [108/227] vs. 72.98% [126/174], <i>p</i> = .04) but similar trend for CVS (36.86% [80/227] vs. 68.81% [114/174], <i>p</i> = .05) and similar rates of HBeAg seroconversion (6.59% [7/103] vs. 7.40% [7/110], <i>p</i> = .89). However, at week 48, there were no statistically significant differences between CHB-FL and non-FL CHB patients in any of the outcomes, including BR (60.03% [213/471] vs. 69.37% [314/717], <i>p</i> = .67), CVS (65.63% [459/746] vs. 73.81% [743/1132], <i>p</i> = .27) and HBeAg seroconversion (10.01% [30/275] vs. 14.06% [65/453], <i>p</i> = .58) with similar findings for week 96. BR rate was lower in CHB-FL patients after 12 weeks of antiviral treatment. However, after a longer follow-up of either 48 or 96 weeks, no statistically significant differences were observed in BR, CVS or HBeAg seroconversion rates between CHB patients with and without FL.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140567961","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 B virus infection and current perspectives on global WHO 2030 eradication","authors":"Shanmugam Saravanan,&nbsp;Esaki M. Shankar,&nbsp;Ramachandran Vignesh,&nbsp;Pitchaipillai Sankar Ganesh,&nbsp;Sathish Sankar,&nbsp;Vijayakumar Velu,&nbsp;Davey M. Smith,&nbsp;Pachamuthu Balakrishnan,&nbsp;Dhivya Viswanathan,&nbsp;Rajakumar Govindasamy,&nbsp;Arcot R. Venkateswaran","doi":"10.1111/jvh.13928","DOIUrl":"10.1111/jvh.13928","url":null,"abstract":"<p>The current World Health Organization (WHO) Hepatitis Elimination Strategy suffers from lack of a target for diagnosing or expunging occult HBV infection. A sizable segment of the global population has an undetected HBV infection, particularly the high-risk populations and those residing in countries like India with intermediate endemicity. There is growing proof that people with hidden HBV infection can infect others, and that these infections are linked to serious chronic hepatic complications, especially hepatocellular carcinoma. Given the current diagnostic infrastructure in low-resource settings, the WHO 2030 objective of obliterating hepatitis B appears to be undeniably challenging to accomplish. Given the molecular basis of occult HBV infection strongly linked to intrahepatic persistence, patients may inexplicably harbour HBV genomes for a prolonged duration without displaying any pronounced clinical or biochemical signs of liver disease, and present histological signs of moderate degree necro-inflammation, diffuse fibrosis, and hence the international strategy to eradicate viral hepatitis warrants inclusion of occult HBV infection.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140567710","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":"Inverse relationship between HBV DNA levels and liver histopathological changes in immune-tolerant CHB patients","authors":"Deliang Huang,&nbsp;Huiyi Lai,&nbsp;Zhibin Zhu,&nbsp;Hong Yu,&nbsp;Jinghan Peng,&nbsp;Yuanyuan Chen,&nbsp;Xuejiao Liao,&nbsp;Jun Chen","doi":"10.1111/jvh.13940","DOIUrl":"10.1111/jvh.13940","url":null,"abstract":"<p>Limited data exist regarding the association between hepatitis B virus (HBV) DNA levels and liver histopathological changes in patients with chronic hepatitis B (CHB) during the immune tolerant (IT) phase. In this study, we retrospectively analysed liver biopsy results from 150 adult IT-CHB patients. The liver tissue necroinflammation and fibrosis were evaluated by the Scheuer scoring system. Multivariate logistic regression, smooth curve fitting, and segmented regression models were used to examine the association between HBV DNA levels and liver histopathological changes. A total of 26%, 30.67% and 42% of IT patients had significant necroinflammation (≥G2), significant fibrosis (≥S2) and significant histopathological changes (≥G2 and/or ≥S2), respectively. HBV DNA levels were independently and non-linear inversely associated with significant necroinflammation and histopathological changes in IT-CHB patients. Patients with HBV DNA levels &lt;10⁷ IU/mL had a higher risk of significant histopathological changes compared to those with levels &gt;10⁷ IU/mL. The findings were further confirmed by smooth curve fitting analyses, subgroup and sensitivity analyses. In segmented regression model analyses, the optimal DNA value for the lowest odds ratio of significant histopathological changes was 7.26 log10 IU/mL. A non-linear inverse association between HBV DNA levels and significant histopathological changes in IT-CHB patients. DNA 7.26 log10 IU/mL may serve as a potential cut-off point to define a ‘true immune tolerant phase’ with minimal liver histopathological changes.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140567998","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":"Preferences and feasibility of long-acting technologies for treatment of hepatitis C virus in low- and middle-income countries: A survey of providers and policymakers","authors":"Neil Gupta,&nbsp;Susan Swindells,&nbsp;Kimberly K. Scarsi,&nbsp;Renae Furl,&nbsp;David L. Thomas,&nbsp;Ethel D. Weld,&nbsp;Joelle Dountio Ofimboudem,&nbsp;Hailemichael Desalegn,&nbsp;Saeed Hamid,&nbsp;Alethse de la Torre Rosas,&nbsp;Angelica E. Miranda,&nbsp;Andrew Owen,&nbsp;Steve Rannard,&nbsp;Lindsey Hiebert,&nbsp;Katherine Sun,&nbsp;John W. Ward","doi":"10.1111/jvh.13921","DOIUrl":"10.1111/jvh.13921","url":null,"abstract":"<p>Long-acting technologies (LATs) for hepatitis C virus (HCV) are under development as a strategy to improve linkage to care, treatment adherence and outcomes. We conducted a survey of HCV treatment prescribers and HCV policymakers in low- and middle-income countries (LMICs) regarding acceptability and feasibility of HCV LATs. We included one-time intramuscular injection, subdermal implant and transdermal patch as potential LAT options. We surveyed participants regarding optimal health system and patient characteristics, concerns, potential barriers, overall feasibility and preferences for HCV LAT as compared to daily oral medication. Overall, 122 providers and 50 policymakers from 42 LMICs completed the survey. Among providers, 93% (113/122) expressed willingness to prescribe LAT and 72% (88/120) of providers preferred LAT if provided at comparable efficacy, safety and cost as current oral treatments. Of providers preferring HCV LAT to daily oral medication, 67% (59/88) preferred injection, 24% (21/88) preferred patch and 9% (8/88) preferred implant. Only 20% (24/122) would prescribe LAT if it were more costly than oral treatment. In regression analysis, no provider characteristics were associated with preference for LAT over oral treatment. Policymakers reported high likelihood that LAT would be included in treatment guidelines (42/50; 84%) and national drug formularies (39/50; 78%) if efficacy, safety and cost were similar to oral treatment. HCV LATs could advance progress to HCV elimination in LMICs by diversifying treatment options to improve treatment coverage and outcomes. Provider preferences from LMICs are a critical consideration in the development of HCV LATs to ensure its early and equitable availability in LMICs.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306097","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":"Performance of HCV core antigen and PCR testing in a predominantly genotype 3 population","authors":"Ammara Naveed,&nbsp;Abdullah Khalid,&nbsp;Naveed Janjua,&nbsp;Gavin A. Cloherty,&nbsp;Saeed Akhter","doi":"10.1111/jvh.13937","DOIUrl":"10.1111/jvh.13937","url":null,"abstract":"<p>Hepatitis C core antigen (HCVcAg) is becoming increasingly recognized as an alternative to molecular testing for the confirmation of chronic hepatitis C. However, there are limited data on the performance of this assay in a genotype 3 (GT3) predominant country like Pakistan. We conducted a study to evaluate the diagnostic performance of HCVcAg against the HCV polymerase chain reaction (PCR) molecular test. HCV antibody-positive patients requiring confirmatory testing were recruited from August to October 2018 at the Pakistan Kidney and Liver Institute and Research Center (PKLI&amp;RC), Lahore, Pakistan. Patients with previously known diagnoses or treatment histories were excluded. The Abbott HCV Ag assay was used for HCVcAg testing. Results ≥3.00 fmol/L were considered positive for HCVcAg. The Abbott RealTime HCV assay was used for PCR testing with a lower detection limit of ≥12 IU/mL. We computed the sensitivity, specificity and correlation of HCVcAg against HCV PCR. A total of 394 patients were recruited. The median age of the patients was 42 years. Most participants were females (51.5%, <i>n</i> = 203), 30.7% (<i>n</i> = 121) had HTN, 10.4% DM (<i>n</i> = 41) and 5% had APRI ≥2. The overall sensitivity was 98.0% and the specificity was 98.6%. The lowest detection limit of cAg was an HCV RNA value of 4657 IU/mL. The levels of cAg were highly correlated with those of HCV RNA by Spearman's rank correlation test (<i>r</i> = 0.935, <i>p</i> &lt; .001). HCVcAg represents a suitable alternative with high sensitivity and specificity compared with HCV PCR in the GT3-predominant population and can be incorporated into algorithms to improve linkage to care.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119973","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":"Direct-acting antivirals in women of reproductive age infected with hepatitis C virus","authors":"Krystyna Dobrowolska,&nbsp;Małgorzata Pawłowska,&nbsp;Dorota Zarębska-Michaluk,&nbsp;Piotr Rzymski,&nbsp;Ewa Janczewska,&nbsp;Magdalena Tudrujek-Zdunek,&nbsp;Hanna Berak,&nbsp;Włodzimierz Mazur,&nbsp;Jakub Klapaczyński,&nbsp;Beata Lorenc,&nbsp;Justyna Janocha-Litwin,&nbsp;Anna Parfieniuk-Kowerda,&nbsp;Dorota Dybowska,&nbsp;Anna Piekarska,&nbsp;Rafał Krygier,&nbsp;Beata Dobracka,&nbsp;Jerzy Jaroszewicz,&nbsp;Robert Flisiak","doi":"10.1111/jvh.13936","DOIUrl":"10.1111/jvh.13936","url":null,"abstract":"<p>Eliminating hepatitis C virus (HCV) infection in the population of women of reproductive age is important not only for the health of women themselves but also for the health of newborns. This study aimed to evaluate the implementation of this goal by analysing the effectiveness of contemporary therapy in a large cohort from everyday clinical practice along with identifying factors reducing therapeutic success. The analysed population consisted of 7861 patients, including 3388 women aged 15–49, treated in 2015–2022 in 26 hepatology centres. Data were collected retrospectively using a nationwide EpiTer-2 database. Females were significantly less often infected with HCV genotype 3 compared to males (11.2% vs. 15.7%) and less frequently showed comorbidities (40.5% vs. 44.2%) and comedications (37.2% vs. 45.2%). Hepatocellular carcinoma, liver transplantation, HIV and HBV coinfections were reported significantly less frequently in women. Regardless of the treatment type, females significantly more often reached sustained virologic response (98.8%) compared to males (96.8%). Regardless of gender, genotype 3 and cirrhosis were independent factors increasing the risk of treatment failure. Women more commonly reported adverse events, but death occurred significantly more frequently in men (0.3% vs. 0.1%), usually related to underlying advanced liver disease. We have demonstrated excellent effectiveness and safety profiles for treating HCV infection in women. This gives hope for the micro-elimination of HCV infections in women, translating into a reduced risk of severe disease in both women and their children.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119972","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":"Predictors of engagement in screening for a hepatitis C virus (HCV) treatment trial in a rural Appalachian community","authors":"Jennifer R. Havens,&nbsp;Michelle R. Lofwall,&nbsp;April M. Young,&nbsp;Michele Staton,&nbsp;Takako Schaninger,&nbsp;Hannah Fraser,&nbsp;Peter Vickerman,&nbsp;Sharon L. Walsh","doi":"10.1111/jvh.13933","DOIUrl":"10.1111/jvh.13933","url":null,"abstract":"<p>An HCV treatment trial was initiated in September 2019 to address the opioid/hepatitis C virus (HCV) syndemic in rural Kentucky. The focus of the current analysis is on participation in diagnostic screening for the trial. Initial eligibility (≥18 years of age, county resident) was established by phone followed by in-person HCV viremia testing. 900 rural residents met the inclusion criteria and comprised the analytic sample. Generalized linear models were specified to estimate the relative risk of non-attendance at the in-person visit determining HCV eligibility. Approximately one-quarter (22.1%) of scheduled participants were no-shows. People who inject drugs were no more likely than people not injecting drugs to be a no-show; however, participants ≤35 years of age were significantly less likely to attend. While the median time between phone screening and scheduled in-person screening was only 2 days, each additional day increased the odds of no-show by 3% (95% confidence interval: 2%–3%). Finally, unknown HCV status predicted no-show even after adjustment for age, gender, days between screenings and injection status. We found that drug injection did not predict no-show, further justifying expanded access to HCV treatment among people who inject drugs. Those 35 years and younger were more likely to no-show, suggesting that younger individuals may require targeted strategies for increasing testing and treatment uptake. Finally, streamlining the treatment cascade may also improve outcomes, as participants in the current study were more likely to attend if there were fewer days between phone screening and scheduled in-person screening.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022136","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":"Leveraging opportunities for treatment/user simplicity (LOTUS): Navigating the current treatment landscape for achieving hepatitis C virus elimination among persons who inject drugs","authors":"Mark S. Sulkowski,&nbsp;Anthony Martinez,&nbsp;Gia L. Tyson,&nbsp;Kathleen Scholz,&nbsp;Ricardo A. Franco,&nbsp;Anita Kohli,&nbsp;Susan F. Julius,&nbsp;Paulina Deming,&nbsp;Scott A. Fink,&nbsp;Keisa Lynch,&nbsp;Marina Roytman,&nbsp;Tuesdae R. Stainbrook,&nbsp;Marshe D. Turner,&nbsp;Matthew Viera-Briggs,&nbsp;Christian B. Ramers","doi":"10.1111/jvh.13927","DOIUrl":"10.1111/jvh.13927","url":null,"abstract":"<p>All-oral, direct-acting antivirals can cure hepatitis C virus (HCV) in almost all infected individuals; yet, many individuals with chronic HCV are not treated, and the incidence of acute HCV is increasing in some countries, including the United States. Strains on healthcare resources during the COVID-19 pandemic negatively impacted the progress toward the World Health Organization goal to eliminate HCV by 2030, especially among persons who inject drugs (PWID). Here, we present a holistic conceptual framework termed LOTUS (Leveraging Opportunities for Treatment/User Simplicity), designed to integrate the current HCV practice landscape and invigorate HCV treatment programs in the setting of endemic COVID-19: (A) treatment as prevention (especially among PWID), (B) recognition that HCV cure may be achieved with variable adherence with evidence supporting some forgiveness for missed doses, (C) treatment of all persons with active HCV infection (viremic), regardless of acuity, (D) minimal monitoring (MinMon) during treatment, and (E) rapid test and treat (TnT). The objective of this article is to review the current literature supporting each LOTUS petal; identify remaining gaps in knowledge or data; define the remaining barriers facing healthcare providers; and review evidence-based strategies for overcoming key barriers.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022117","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":"Racial discrimination, knowledge, and health outcomes: The mediating role of hepatitis B-related stigma among patients with chronic hepatitis B","authors":"Julia G. Katcher,&nbsp;Ann C. Klassen,&nbsp;Hie-Won Hann,&nbsp;Mimi Chang,&nbsp;Hee-Soon Juon","doi":"10.1111/jvh.13932","DOIUrl":"10.1111/jvh.13932","url":null,"abstract":"<p>It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty-five CHB patients were recruited and enrolled from two clinics in Philadelphia and Los Angeles. Depressive symptoms were measured using the Patient Health Question-9 (PHQ-9), physical health via self-rated health survey and stigma via hepatitis B quality of life (HBQOL)—stigma survey. Perceived racial discrimination and knowledge of CHB sequelae were independent variables. The cohort had an average age of 60.1 years (range 19–84, SD 10.7), 56% were male and 94% were born in South Korea. Mediational analysis found that stigma was a significant mediator between both racial discrimination (indirect effect = .037, Bootstrap 95% CI = [.010–.064]) and sequelae knowledge (indirect effect = .097, Bootstrap 95% CI = [.018–.176]) and depressive symptoms. Stigma also had a direct effect on depressive symptoms (<i>β</i> = .136, <i>p</i> &lt; .01) and self-rated health (<i>β</i> = .018, <i>p</i> &lt; .05). In addition, age, gender, education and employment were related to health outcomes. The findings of this study indicate that HBV-related stigma is an important mediator of mental health outcomes in this population. Future studies should identify other psychosocial factors to develop effective intervention programs to reduce stigma and improve quality of life among CHB patients.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.13932","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972496","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}