Journal of Viral Hepatitis最新文献

{"title":"Delivering Effective Hepatitis C Virus Treatment in an Embedded Primary Care Setting Within a Tertiary Care Hospital in Karachi, Pakistan","authors":"Sabeen Shah,&nbsp;Nyashadzaishe Mafirakureva,&nbsp;Adam Trickey,&nbsp;Aliya Hasnain,&nbsp;Uzma Khan,&nbsp;Saira Khowaja,&nbsp;Hiba Ashraf,&nbsp;Naila Baig-Ansari,&nbsp;Matthew Hickman,&nbsp;Peter Vickerman,&nbsp;Josephine G. Walker,&nbsp;Aaron G. Lim","doi":"10.1111/jvh.70164","DOIUrl":"10.1111/jvh.70164","url":null,"abstract":"<p>Hepatitis C virus (HCV) endemic regions require accessible treatment interventions. Effectiveness and costs of a pilot HCV treatment programme were evaluated at an embedded primary care service within a tertiary care centre at Indus Hospital and Health Network in Karachi, Pakistan. Data on patients (<i>n</i> = 1288, median age 40 years) initiating direct-acting antiviral (DAA) treatment (October 2016 to December 2018) were extracted from hospital records. Eligible patients had chronic HCV, were treatment naïve, and without hepatic decompensation. Multivariable logistic regression analysed factors associated with treatment outcomes (not completing treatment, treatment completion without sustained virological response test at 12 weeks (SVR12) visit, and treatment completion with SVR12). Costs (2019 USD) were estimated using micro-costing from financial records and staff interviews. Among 1288 patients (63% women), 93% (1200/1288) completed treatment, and 74% (884/1200) attended SVR12 visit, with 98% (<i>n</i> = 870/884) cured. Compared with 0–29 year-olds, incomplete treatment was lower among 30–49 year-olds (aOR 0.47 [0.26–0.83]) and ≥ 50 year-olds (aOR 0.48 [0.24–0.93]). SVR12 non-attendance was higher for 24-week versus 12-week regimens (aOR: 3.46 [1.51–7.93]), but lower for patients with APRI scores 0.5–1.49 (aOR 0.69 [0.50–0.96]) and ≥ 1.5 (aOR 0.44 [0.24–0.78]) compared to 0–0.49. The mean treatment cost was $370.74 per patient, driven by clinic visits $271.80 (73.3%), labs $68.32 (18.4%), and DAAs $30.62 (8.3%). Overall, a high treatment completion and cure rate were achieved, with a low average cost per patient, indicating that this HCV treatment model can be affordable and may be considered for widescale treatment scale-up in Pakistan.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434081","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":"Hepatitis B Vaccine Response in Children of Vaccinated Versus Unvaccinated Mothers: A Retrospective Cohort Study","authors":"Safa Shibli,&nbsp;Mohamad Suki,&nbsp;Tannous Korzom,&nbsp;Manfred S. Green,&nbsp;Rifaat Safadi","doi":"10.1111/jvh.70165","DOIUrl":"10.1111/jvh.70165","url":null,"abstract":"<p>Universal infant hepatitis B (HBV) vaccination is highly effective in preventing infection. However, little is known about whether a mother's HBV vaccination history influences her child's immune response to routine immunisation. We aimed to compare vaccine-induced antibody responses in children of vaccinated and unvaccinated mothers. We conducted a historical-retrospective cohort study of 364 children who completed the standard infant HBV vaccination series and underwent post-vaccination antibody testing. Maternal vaccination status was determined by serology, medical records and cohort year. Children were classified as offspring of HBsAg-negative vaccinated mothers (<i>n</i> = 92), HBsAg-negative unvaccinated mothers (<i>n</i> = 174), or HBsAg-positive mothers (<i>n</i> = 98), who also received hepatitis B immunoglobulin (HBIG) at birth. Anti-HBs titers were analysed and categorised. Ordinal logistic regression was used to assess associations. Overall seroprotection rates (≥ 10 mIU/mL) were high (89.3%) and did not differ significantly between groups. However, children born to mothers vaccinated prior to pregnancy were significantly more likely to achieve very high antibody levels (≥ 1000 mIU/mL) compared with children of unvaccinated mothers or those who received HBIG at birth (<i>p</i> &lt; 0.05). This association was most pronounced in children tested at ≤ 3 years of age. Mean anti-HBs titers were also highest in offspring of vaccinated mothers. While older maternal age and lower haemoglobin levels impaired the response, the HBIG did nothing. While infant HBV seroprotection rates were uniformly high regardless of maternal background, children born to mothers vaccinated against HBV prior to pregnancy exhibited a more robust early antibody response (≥ 1000 mIU/mL). These findings suggest a possible intergenerational enhancement of vaccine responsiveness and may affect long-term implications for HBV vaccination strategies.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390195","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":"A New Model for Hepatitis C Elimination: CDC-Dispatching Follow-Up Coordinators Stationed in Hospitals","authors":"Jingcheng Xu,&nbsp;Yi Cao,&nbsp;Yingqi Xiao,&nbsp;Weiqing Li,&nbsp;Minchang He,&nbsp;Yongchun Li","doi":"10.1111/jvh.70163","DOIUrl":"10.1111/jvh.70163","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aimed to establish and evaluate a three-tiered closed-loop management model for hepatitis C involving ‘CDC-community-follow-up coordinators’, so as to improve the referral rate and DAA treatment rate for previously diagnosed but untreated (DBU) patients, enhance the diagnosis and treatment coverage for in-hospital HCV antibody-positive patients, and accelerate the elimination of hepatitis C. In April 2024, the novel ‘CDC-community-stationed follow-up coordinators’ model for hepatitis C management was launched in Nanhai District, Foshan City, with the CDC coordinating the recall of historical DBU patients; through government-procured third-party follow-up services, stationed follow-up coordinators were assigned to Nanhai District People's Hospital to facilitate the follow-up, diagnosis and treatment of both in-hospital patients and external DBU patients, while comparisons were conducted between pre- and post-implementation periods regarding HCV RNA testing rates, DAA treatment rates and diagnosis-to-treatment delays, and treatment adherence and completion rates across different populations were assessed. A total of 4975 DBU patients between 2004 and 2024 were identified from the CDC database, and after 3 months of telephone follow-up, the response rate was 38.21% (1901/4975), the recall rate 23.55% (401/1703), the HCV RNA positivity rate 25.69% (103/401), and the DAA treatment rate 54.4% (56/103). After the implementation of the model, the in-hospital HCV RNA testing rate for anti-HCV-positive patients increased from 68.1% (738/1084, January 2022–March 2024) to 90.97% (393/432, April–December 2024), and the DAA treatment rate rose from 43.1% (116/269, January 2022–March 2024) to 76.7% (92/120, April–December 2024); the mean time from antibody positivity to RNA testing decreased from 19.3 days to 11.0 days, and the time from diagnosis to treatment initiation shortened from 42.2 days to 22.6 days. The CDC-dispatching stationed follow-up coordinator model enables effective link-to-care for DBU patients and significantly improves the diagnosis and treatment rates of in-hospital HCV cases, demonstrating strong potential for scaling up in resource-limited settings.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390425","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":"Prolonged Intrahepatic Cholestasis After Acute Hepatitis E Infection: A Case Series and Genetic Analysis","authors":"Montserrat Fraga,&nbsp;Sophie Kasmi,&nbsp;Susanne N. Weber,&nbsp;Roman Liebe,&nbsp;Christine Sempoux,&nbsp;Ali Saadat,&nbsp;Jacques Fellay,&nbsp;Silke Kenngott-Kelber,&nbsp;Vincent Zimmer,&nbsp;Frank Lammert,&nbsp;Marcin Krawczyk,&nbsp;Christoph Jüngst","doi":"10.1111/jvh.70156","DOIUrl":"10.1111/jvh.70156","url":null,"abstract":"<p>Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis worldwide. Whereas HEV infection is typically self-limiting, rare cases of prolonged cholestasis have been reported. The underlying mechanisms remain unclear, though host genetic variation may contribute. This study aimed to investigate the role of genetic predisposition in HEV-induced prolonged cholestasis by analysing variants in genes associated with hepatocanalicular transport. We performed a retrospective review of medical records from three university centres in Switzerland and Germany and identified five immunocompetent patients with prolonged cholestasis following acute HEV infections. Genetic analysis using next-generation sequencing included a panel of five genes involved in cholestatic liver diseases (<i>ATP8B1, ABCB11</i>, <i>ABCB4, ABCC2</i> and <i>MYO5B</i>). Variant frequencies were evaluated using population reference databases and compared with a genetically characterised cohort of asymptomatic HEV-infected blood donors. All five patients were male, with a median age of 59 years. The median duration of cholestasis exceeded 77 days. Two patients exhibited potentially pathogenic heterozygous variants: <i>ATP8B1</i> p.N45T in one patient and <i>MYO5B</i> p.K429R in another. Additionally, common <i>ABCB11</i> variants were detected in all patients, which might have contributed to cholestatic clinical presentation. In the asymptomatic HEV-infected controls, the <i>MYO5B</i> p.K429R variant was absent, whereas the <i>ATP8B1</i> p.N45T variant was detected in only one individual in a heterozygous state. These case series illustrate that host genetics might influence the severity of HEV infection, particularly prolonged cholestatic jaundice. Further research is needed to explore the interaction between viral infections and host genetics in liver disorders.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378048","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":"The Impact of Ambient Temperature on HCC Risk in Patients With Chronic Hepatitis B","authors":"Tyng-Yuan Jang","doi":"10.1111/jvh.70166","DOIUrl":"10.1111/jvh.70166","url":null,"abstract":"","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366037","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":"Prevalence and Factors Associated With Hepatitis C in Danish Prisons, 2022–2024: A Multicentre Cross-Sectional Study","authors":"Jonas Demant,&nbsp;Jacob Søholm,&nbsp;Jeffrey V. Lazarus,&nbsp;Louise Krohn-Dehli,&nbsp;Christina Egelund,&nbsp;Søren Madsen,&nbsp;Toke Barfod,&nbsp;Cécile Kremer,&nbsp;Stephen Strunge Nilsson,&nbsp;Ditte Andersen Skovdal,&nbsp;Nina Weis","doi":"10.1111/jvh.70154","DOIUrl":"10.1111/jvh.70154","url":null,"abstract":"<p>Prisons offer a critical opportunity for hepatitis C virus (HCV) elimination, yet current data from Danish correctional facilities are sparse. We conducted a cross-sectional study in 16 prisons across Eastern Denmark between October 2022 and August 2024, enrolling 651 incarcerated individuals. All participants underwent HCV antibody and RNA testing using dried blood spots and completed a bio-behavioural risk survey. The prevalence of HCV antibody and HCV RNA was 4.2% (<i>n</i> = 26) and 2.0% (<i>n</i> = 13) respectively. HCV exposure was most prevalent among individuals with a history of injecting drug use (56.4%), women (11.3%) and foreign-born individuals (6.7%). In multivariable logistic regression, HCV exposure was significantly associated with injecting drug use (adjusted odds ratio [aOR] 209.11, 95% confidence interval [CI]: 36.16–1209.27), female sex (male vs. female: aOR 0.18, 95% CI: 0.05–0.60) and being born in a low-prevalence country (aOR 6.22, 95% CI: 1.64–23.61). We observed substantial site-level variation and care gaps that disproportionately affect marginalised groups. These findings support the implementation of targeted HCV screening at prison intake, along with facility-specific and population-tailored interventions, as essential strategies for achieving Denmark's commitment to the World Health Organization's HCV elimination goal.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344610","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":"Prevalence of Active HCV Infection in Spain in 2022 Using Multiparameter Evidence Synthesis","authors":"Christos Thomadakis,&nbsp;Ilias Gountas,&nbsp;Konstantinos Gountas,&nbsp;Nestor Nuño,&nbsp;Begoña Brime,&nbsp;Rosario Sendino,&nbsp;Agustín Albillos,&nbsp;María Buti,&nbsp;Javier Crespo,&nbsp;Juan Berenguer,&nbsp;Sonia Alonso,&nbsp;Alberto Díaz de Santiago,&nbsp;Victoria Hernando,&nbsp;Montserrat Laguno,&nbsp;Sabela Lens,&nbsp;Moisés Diago,&nbsp;Maria Luisa Montes,&nbsp;Javier García-Samaniego,&nbsp;Luis Morano,&nbsp;Juan Luis Moreno,&nbsp;Jordi Navarro,&nbsp;Manuel Romero-Gómez,&nbsp;Laura Santos,&nbsp;Raúl Soriano,&nbsp;Erika Duffell,&nbsp;Asuncion Diaz,&nbsp;Julia del Amo,&nbsp;Georgios Nikolopoulos","doi":"10.1111/jvh.70159","DOIUrl":"10.1111/jvh.70159","url":null,"abstract":"<p>Hepatitis C virus (HCV) remains a major public health concern worldwide. Spain has implemented large-scale direct-acting antiviral (DAA) treatment programs, yet the prevalence of active HCV infection (aHCV) and its trends over time remain incompletely characterised. We applied Bayesian multiparameter evidence synthesis (MPES) to estimate the prevalence of aHCV in Spain in 2022 and its change from 2019 to 2022. The Spanish population aged 15–79 years was stratified into four non-overlapping risk groups: current people who inject drugs (PWID), ex-PWID, gay-bisexual and other men who have sex with men (GBMSM) engaging in chemsex (GBMSMchem), and the general population. Data sources included, among others, national seroprevalence surveys, behavioural studies, national databases, and clinical records on DAA treatment outcomes. The estimated overall aHCV prevalence in Spain in 2022 was 0.14% (95% Credible Interval: 0.05%–0.27%), corresponding to approximately 54,500 individuals. Prevalence was highest among current PWID (12.5%) and GBMSMchem (8.4%). Compared to 2019, the total number of aHCV cases declined by ~20,000, largely attributable to DAA treatment. Among the general population, 29.4% of aHCV cases remained undiagnosed, with the highest prevalence in individuals aged 50–59 (0.25%) and 60–69 (0.16%) years. Spain has made substantial progress towards HCV elimination, but key populations such as PWID and GBMSMchem remain at high risk. Targeted interventions, including expanded harm reduction services and accessible HCV testing and treatment, are essential to achieving the World Health Organization (WHO) elimination targets by 2030.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344596","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":"Prevalence, Clinical Presentation and Outcome of Hepatitis B Patients With Indeterminate Phase: A Systematic Review and Meta-Analysis","authors":"Jie Li,&nbsp;Xiaoming Xu,&nbsp;Jiacheng Liu,&nbsp;Ming Li,&nbsp;Rahma Issa,&nbsp;Xue Bai,&nbsp;Leslie Yeeman Kam,&nbsp;Christopher Donald Stave,&nbsp;Wenjing Ni,&nbsp;Fajuan Rui,&nbsp;Yixuan Zhu,&nbsp;Xiaoyan Ma,&nbsp;Qi Gu,&nbsp;Yifan Pan,&nbsp;Chao Wu,&nbsp;Mindie H. Nguyen","doi":"10.1111/jvh.70161","DOIUrl":"10.1111/jvh.70161","url":null,"abstract":"<div>\u0000 \u0000 <p>Although current guidelines classify the natural history of chronic hepatitis B (CHB) into several immune phases, a substantial proportion of patients with CHB do not meet criteria for any of the defined immune phases and are considered to be in an indeterminate phase. We aim to perform a meta-analysis to systematically evaluate the prevalence, clinical presentation and outcome of indeterminate CHB patients classified according to American Association for the Study of Liver Diseases (AASLD) 2018 guidelines or European Association for the Study of the Liver (EASL) 2017 guidelines. We searched four databases from inception to Aug 21, 2024, for studies reporting the prevalence, characteristics and/or clinical outcomes of patients with indeterminate CHB classified according to AASLD 2018 guidelines or EASL 2017 guidelines. Of the 4553 studies initially identified, 50 studies met study inclusion criteria and were analysed. The prevalence of indeterminate patients was 38.90% (95% CI: 33.51–44.57) and 38.81% (95% CI: 31.22–46.99) by AASLD 2018 and EASL 2017 guidelines, respectively. Among indeterminate CHB patients, the pooled incidence rate per 1000 person-years for hepatocellular carcinoma and liver-related events was 5.36 (95% CI: 1.38–9.35) and 7.27 (95% CI: 0.00–22.21) per AASLD 2018 guidelines and 5.20 (95% CI: 1.41–8.99) and 9.79 (95% CI: 0.00–25.35) per EASL 2017 guidelines, respectively. Indeterminate phase affects nearly 40% of CHB patients who are at risk for hepatocellular carcinoma and liver-related adverse outcomes. Further research is needed to inform treatment strategies specifically tailored for the indeterminate CHB patients.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317319","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 Impact of Hepatitis C and Socio-Demographic Variables on Health-Related Quality of Life in Pakistan: Cross-Sectional Study","authors":"Siwaporn Niyomsri,&nbsp;Aaron G. Lim,&nbsp;Ambreen Arif,&nbsp;Muhammad Asim,&nbsp;Auj Chaudhry,&nbsp;Naheed Choudhry,&nbsp;Aliya Hasnain,&nbsp;Polychronis Kemos,&nbsp;Chris Metcalfe,&nbsp;Asad Choudhry,&nbsp;Saeed Sadiq Hamid,&nbsp;Saad Niaz,&nbsp;Huma Qureshi,&nbsp;Graham R. Foster,&nbsp;Peter Vickerman,&nbsp;Josephine G. Walker,&nbsp;HepFreePak team","doi":"10.1111/jvh.70139","DOIUrl":"10.1111/jvh.70139","url":null,"abstract":"<p>Approximately 8.8 million people are living with chronic hepatitis C virus (HCV) in Pakistan. We assessed factors related to health-related quality of life (HRQoL) among the general population screened for HCV and calculated the national burden in quality-adjusted life years (QALYs). A cross-sectional study was conducted in community and clinic-based settings in Karachi and Gujranwala. HRQoL was assessed before diagnosis using EQ-5D-3L (Pakistan value set). Propensity score matching (PSM) was used to address socio-economic differences between HCV RNA-positive (viraemic) and HCV-antibody-negative participants. We assessed socio-demographic and HCV-related predictors of HRQoL (Tobit regression) and problems by EQ-5D domain (logistic regression). The HCV transmission model was used to estimate the burden of HCV in terms of morbidity- and mortality-related QALY loss in 2024. After PSM, 778 individuals remained in each group from a total of 5468 participants. HCV-positive participants had lower HRQoL (EQ-5D-3L score, <i>p</i> &lt; 0.001) and higher odds of problems in all five EQ-5D dimensions. Lower HRQoL was associated with older age and unemployment, while married or Urdu-speaking participants had higher HRQoL. There was little evidence that cirrhosis was associated with HRQoL (<i>p</i> = 0.140) among HCV-positive participants. The total estimated QALY loss due to HCV in Pakistan in 2024 was 804,580 QALYs, of which 55% was due to mortality. HCV infection is associated with reduced HRQoL and substantial QALY losses in Pakistan. Our findings emphasise the role of socio-demographic variables on HRQoL. Further research in Pakistan is needed to determine if HCV treatment can mitigate these effects.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317309","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":"Enhancing Chronic Hepatitis B and D Management Through a Tailored Mobile Health Application: Real-World Outcomes From the Adaptation of the NORA App","authors":"Judit Romero-Vico,&nbsp;Anna Feliu,&nbsp;Elena Vargas-Accarino,&nbsp;Ester Sánchez-Gavilán,&nbsp;Marc Ribó,&nbsp;Adriana Palom,&nbsp;Juan Carlos Ruiz-Cobo,&nbsp;Mar Riveiro,&nbsp;Núria Fabrellas,&nbsp;Maria Buti","doi":"10.1111/jvh.70160","DOIUrl":"10.1111/jvh.70160","url":null,"abstract":"<div>\u0000 \u0000 <p>Chronic hepatitis B (CHB) and hepatitis D (CHD) remain global health challenges, where sustained care engagement, treatment adherence and regular monitoring are essential but often limited by stigma and healthcare access. Digital health tools offer new opportunities to bridge these gaps. This study aimed to adapt the NORA mobile health app for CHB and CHD patients and evaluate its real-world utility in improving knowledge, adherence, communication and quality of life. We conducted a prospective, comparative study (February 2022–April 2024) including adult CHB (HBsAg-positive, HBeAg-negative) or CHD (anti-HDV or HDV-RNA-positive) patients with mobile access and Spanish proficiency. The app offered educational content, medication reminders, quality-of-life questionnaires (CLDQ, FACIT-F, EQ-5D-5L), a chat function and a knowledge test. Sociodemographic, clinical and usage data were analysed. Of 406 patients evaluated (356 CHB, 50 CHD), 277 CHB and 41 CHD patients were eligible. Participation was high (CHB: 88.4%; CHD: 90.2%), with active use in 48.1% and 70.3%, respectively. App users were more often male and Caucasian, and CHD users more frequently had detectable HDV-RNA. Patients with inactive HBV infection were less likely to use the app over the medium term (OR = 0.462, <i>p</i> = 0.003), and those who did use the app missed fewer clinic visits than nonusers (8.4% vs. 18.1%; OR = 0.41, <i>p</i> = 0.016). Among users, 85 were on antiviral therapy, 67% used the medication reminder, and chat use was higher in CHD and in treated patients (<i>p</i> = 0.004). High adherence (68% CHB, 84% CHD) and knowledge gains were observed, particularly in CHB with higher education. CHD patients showed worse baseline quality of life and greater declines over time. This first real-world study of a tailored mobile health (mHealth) app for CHB and CHD showed improved patient knowledge, adherence, communication and quality-of-life monitoring, with greater engagement in patients with advanced disease.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276625","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}