Journal of Viral Hepatitis最新文献

{"title":"Trends in Use of Direct-Acting Antivirals for Treatment of Hepatitis C Virus Infection in Australia 2016–2024","authors":"Chieu-Hoang Ly Luong,&nbsp;Lisa Kalisch Ellett,&nbsp;Nicole Pratt,&nbsp;Kirsten Staff,&nbsp;Jack Janetzki","doi":"10.1111/jvh.70082","DOIUrl":"https://doi.org/10.1111/jvh.70082","url":null,"abstract":"<p>Direct-acting antivirals (DAAs) have transformed hepatitis C virus (HCV) treatment in Australia since their inclusion on the Pharmaceutical Benefits Scheme (PBS) in 2016. Treatment has shifted from genotype-specific to pan-genotypic regimens, with glecaprevir/pibrentasvir and sofosbuvir/velpatasvir now recommended in clinical guidelines. This study examined trends in DAA dispensing in light of evolving treatment regimens. A retrospective analysis of publicly available PBS data was conducted, assessing monthly DAA dispensings from March 2016 to December 2024. Dispensings were summarised by count and proportion, PBS item code, schedule (general, private, or public hospital) and number of repeats as a proxy for treatment duration. Dispensing volumes of DAAs increased following PBS-listing in March 2016, with the highest number of dispensings observed between 2016 and 2017 (average of 11,378 prescriptions dispensed per month). Dispensing rates subsequently declined, with an average of 1583 prescriptions dispensed per month from 2020 to 2024. Since introduction to market in August 2017, sofosbuvir with velpatasvir (pan-genotypic regimen) has maintained an average market share of 55%. Glecaprevir/pibrentasvir (pan-genotypic regimen) has maintained an average market share of 34% since its introduction in August 2018. Sofosbuvir/velpatasvir/voxilaprevir, listed on the PBS in April 2019, and used for salvage therapy, has had a smaller average market share of 4% since listing. Pan-genotypic regimens now account for nearly all DAA use in Australia. Declining dispensing rates may reflect reduced new infections and treatment fatigue. Increasing retreatment rates underscore the need for ongoing monitoring and real-world evaluations. Future head-to-head comparisons may support optimal regimen selection.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 10","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998713","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":"Demographic and Clinical Characteristics of Patients With Hepatitis C and Hepatitis B Co-Infection, Georgia, 2017–2023","authors":"Senad Handanagic,&nbsp;Shaun Shadaker,&nbsp;Davit BaliashvilI,&nbsp;Irina Tskhomelidze Schumacher,&nbsp;Paige A. Armstrong,&nbsp;Rania A. Tohme,&nbsp;Maia Butsashvili","doi":"10.1111/jvh.70067","DOIUrl":"https://doi.org/10.1111/jvh.70067","url":null,"abstract":"<div>\u0000 \u0000 <p>Persons co-infected with hepatitis C virus and hepatitis B virus (HCV-HBV) are at increased risk of developing liver disease compared with mono-infected individuals. In Georgia, all patients undergoing hepatitis C treatment are eligible for free testing for hepatitis B surface antigen (HBsAg). However, further hepatitis B evaluations and treatment are not free. We explored demographic and clinical characteristics associated with HCV-HBV co-infection among persons treated for HCV infection. Persons aged ≥ 18 years with HCV infection who initiated HCV treatment during 2017–2023 were included. Patients were grouped as HCV mono-infected, HCV-HBV co-infected (HBsAg positive), and HBV exposed (total HBV core antibody positive, HBsAg negative). We present descriptive analysis and adjusted prevalence ratios (aPR) with 95% confidence intervals (95% CI). Of 54,994 adults treated for hepatitis C, 68.1% had HCV mono-infection, 29.3% were previously exposed to HBV, and 2.6% had HCV-HBV co-infection. Persons who were aged 18–45 years (aPR: 1.75, 95% CI: 1.48–2.08), male (aPR: 1.38, 95% CI: 1.11–1.71), reported ever injecting drugs (aPR: 1.40, 95% CI: 1.19–1.66), had end-of-HCV treatment, alanine transaminase (ALT) levels &gt; 80 IU/L (aPR: 2.14, 95% CI: 1.40–3.29) and did not achieve hepatitis C cure after treatment (aPR: 1.83, 95% CI: 1.13–2.95) were more likely to have HCV-HBV co-infection vs. HCV mono-infection. Patients who did not achieve cure and had persistently higher ALT levels after hepatitis C treatment were more likely to have HCV-HBV co-infection. Expanded access to hepatitis B care and treatment, and co-management of HBV infection along with HCV treatment in co-infected persons are needed to improve clinical outcomes.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 10","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934747","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":"Assessment of Hemophagocytic Lympho-Histiocytosis (HLH) in the Setting of Adult Acute Liver Failure","authors":"Ahmad Anouti,&nbsp;Hamza Dahshi,&nbsp;Jody Rule,&nbsp;Christian Wysocki,&nbsp;William M. Lee,&nbsp;Shannan R. Tujios","doi":"10.1111/jvh.70050","DOIUrl":"https://doi.org/10.1111/jvh.70050","url":null,"abstract":"<p>Hemophagocytic lympho-histiocytosis (HLH) is a life-threatening disease, only occasionally presenting as acute liver failure (ALF) in adults. HLH is challenging to diagnose. We reviewed the ALF Study Group (ALFSG) registry for suspected HLH subjects, as well as 184 with other ALF etiologies for cases that might have been missed, assessing standard laboratory tests, as well as interleukin-18 (IL-18) and soluble interleukin-2 receptor (sIL-2r), to determine the diagnostic utility of these biomarkers. We also calculated standard diagnostic algorithms (H score, HLH-2004 diagnostic criteria) to assess their value. Within 3364 ALF subjects, only 14 were initially cited as HLH. Upon thorough review by an adjudication committee, 5/14 (35.7%) were considered definite, five probable, two possible, and two unlikely. Definite HLH patients had significantly higher ferritin (<i>p</i> = 0.047), IL-18 (<i>p</i> = 0.003) and s-IL2r (<i>p</i> = 0.005) levels, H scores (<i>p</i> &lt; 0.001) and HLH scores (<i>p</i> &lt; 0.001). Other etiologies (APAP, DILI and viral) showed lower IL-18 and sIL2r levels and scores, but overlapping ferritins. Several probable/possible HLH cases lacked complete data for scoring. No additional (missed) HLH cases were identified. HLH remains a rare cause of ALF. Biomarkers, particularly IL-18 and sIL-2r, appear of value. HLH and H scores were also helpful but limited when data was missing.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758522","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":"CHIME: Sofosbuvir/Velpatasvir (S/V) for the Treatment of HCV Infection Among Vulnerable Inner-City Residents","authors":"Brian Conway,&nbsp;Shana Yi,&nbsp;Daivd Truong","doi":"10.1111/jvh.70057","DOIUrl":"https://doi.org/10.1111/jvh.70057","url":null,"abstract":"<div>\u0000 \u0000 <p>The combination of Sofosbuvir/Velpatasvir(S/V) is approved for the treatment of chronic HCV infection. In registrational trials, cure rates of 95% or more were achieved when administered as one pill per day for a period of 12 weeks, regardless of genotype or disease stage. There is a need to develop and evaluate systems of care in populations excluded from clinical trials. We aim to evaluate the safety and efficacy of S/V in a prospective study of HCV-infected inner-city residents enriched for risk behaviours for non-adherence to therapy, including problematic drug use and unstable housing. Through dedicated outreach events, we identified HCV-infected patients who were not currently engaged in health care and who were eligible to receive government-funded antiviral treatment for HCV infection. We offered them the opportunity to enrol in a multidisciplinary programme of care to address medical, psychological, social, and addiction-related needs, and provide S/V therapy in this context, with enhanced supervision of adherence. We identified 222 eligible subjects, 31.5% female, median age of 47 (24–81) years. The most common genotype was 1, followed by 3 (48.2%, 38.7%) and 21.2% scored F3-F4 FibroScan scores. 55.9% have unstable housing, and 98.6% are active drug users, with the majority utilising fentanyl, followed by amphetamines (82.9%, 64.9%). HCV treatment has been started in all 222 persons within a median of 6 weeks of engagement in care. 218 persons completed treatment, one individual withdrew from the treatment, and 3 overdose deaths were documented. HCV cure was documented in 211/218 (96.8%). Virologic relapse was documented in the other 7 cases. The intent-to-treat SVR rate of HCV treatment with S/V was 211/222 (95.0%). Taken together, our data validate the development of multidisciplinary programmes such as ours to address HCV infection, yielding high rates of engagement and retention in care, promoting initiation of treatment (usually within 6 weeks) and &gt; 97% rate of cure.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657585","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":"Trends and Socio-Demographic Patterns of Hepatitis B Virus Hospitalisations in Poland: A 12-Year Nationwide Analysis","authors":"Agnieszka Genowska,&nbsp;Krystyna Dobrowolska,&nbsp;Dorota Zarębska-Michaluk,&nbsp;Piotr Tyszko,&nbsp;Krzysztof Kanecki,&nbsp;Katarzyna Lewtak,&nbsp;Paweł Goryński,&nbsp;Jerzy Jaroszewicz,&nbsp;Piotr Rzymski,&nbsp;Robert Flisiak","doi":"10.1111/jvh.70059","DOIUrl":"https://doi.org/10.1111/jvh.70059","url":null,"abstract":"<div>\u0000 \u0000 <p>Although acute hepatitis B virus (HBV) infections in Europe have declined, thousands of chronic cases are still identified annually, placing a strain on healthcare systems. This study aimed to retrospectively analyse the patient profile, hospitalisation course, and admission causes for HBV infection in Poland in 2012–2023. The first-time HBV hospital admissions in Poland (ICD-10 codes B16; B18.0–B18.1) between 2012 and 2023 (<i>n</i> = 29,435) were analysed, examining trends by gender, age, residence and admission mode. The HBV first-time hospitalisation rate fell over tenfold, from 17.59 per 100,000 population in 2012 to 1.67 in 2021, rising to 3.45 in 2023. During 2020–2022, the share of hospitalisations with acute HBV increased (9.3% vs. 3.8% pre-pandemic; <i>p</i> &lt; 0.05), but their rate was twofold lower (0.18 vs. 0.32 per 100,000 population). The mean patient age rose from 40.9 in 2012 to 51.5 years in 2023 (<i>p</i> &lt; 0.05). Men from urban areas accounted for most hospitalisations, were older than rural patients, and had the highest emergency admission rates. Women from rural areas had the lowest hospitalisation share, were younger, and had over three times fewer emergency admissions. From 2012 to 2023, Poland experienced a major decline, then a resurgence, in HBV hospitalisations, with a higher share of acute cases during the COVID-19 pandemic. Hospitalised patients aged significantly, with urban men most affected. These patterns underscore the need for targeted HBV prevention and management strategies for aging urban populations.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647094","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":"Duration of Nucleos(t)ide Analogue Treatments in Patients With Chronic Hepatitis B Virus Infection in the United States","authors":"Seth Anderson,&nbsp;Vera Gielen,&nbsp;Anna D. Coutinho,&nbsp;Laura Clark,&nbsp;Christopher Bell,&nbsp;Shayon Salehi,&nbsp;Renee Gennarelli,&nbsp;Eileen Farrelly,&nbsp;Dana Stafkey,&nbsp;Robert Gish","doi":"10.1111/jvh.70055","DOIUrl":"https://doi.org/10.1111/jvh.70055","url":null,"abstract":"<p>Viral hepatitis caused by hepatitis B virus accounts for a significant disease burden. Nucleos(t)ide analogues (NAs) are the standard of care for chronic hepatitis B (CHB) infection; however, treatment is long-term, and viral eradication resulting in cure is rare. Adherence to NAs is vital for disease control. Here, we describe real-world treatment patterns among adult patients with CHB infection initiating second-generation NAs in the United States. This retrospective cohort study used United States administrative claims data. From the January 1, 2006 to July 31, 2023 period, we identified patients aged ≥ 18 years diagnosed with CHB infection who initiated second-generation NAs. Patient characteristics and real-world NA utilisation measures were reported, including time to discontinuation, resumption of NA treatment, adherence and predictors of adherence. In total, 6696 patients met the study eligibility criteria. Mean age was 47.2 (standard deviation: 11.5) years, and 41.6% of patients were female. The most common index NA treatments were tenofovir alafenamide (48.5%) and entecavir (41.7%). Median follow-up duration was 24.4 months. Overall, 40.6% of patients discontinued treatment; discontinuation probability was 29.4% at 12 months and 55.6% at 5 years. Of those who discontinued, 45.7% restarted during the study period. Mean adherence (proportion of days covered [PDC]) was 0.91, and 86.5% of participants had a PDC ≥ 80%. This study highlights the challenge of long-term persistence with NA treatment. An unmet need in CHB infection management is novel treatments with finite durations that offer an opportunity to achieve cure and mitigate disease progression.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635434","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":"Non-Specialist Physicians Successfully Treat Hepatitis C Infection With Simplified Care Pathway in France","authors":"Denis Ouzan,&nbsp;Laurent Cattan,&nbsp;Vincent Leroy,&nbsp;Jean Pierre Bronowicki,&nbsp;Alexandra Heurgué,&nbsp;Dan Pospait,&nbsp;Ghassan Riachi,&nbsp;Christophe Renou,&nbsp;Michel Antoni,&nbsp;Laure Ekrief,&nbsp;Laurent Cuissard,&nbsp;Magdalena Meszaros,&nbsp;Jean-Jacques Meurisse,&nbsp;Laurent Roudiere,&nbsp;Thierry Constant,&nbsp;Kouadjo Joseph Koffi,&nbsp;Hatem Salloum,&nbsp;Juliette Foucher,&nbsp;Philippe Gouiry,&nbsp;Malek Bentayeb,&nbsp;Laura E. Telep,&nbsp;Teri Chew,&nbsp;Nicolas J.-P. Martin,&nbsp;Stanislas Pol,&nbsp;the HELIOS study group","doi":"10.1111/jvh.70058","DOIUrl":"https://doi.org/10.1111/jvh.70058","url":null,"abstract":"<p>To eliminate hepatitis C virus (HCV) infection in France, prescribing rights for sofosbuvir/velpatasvir (SOF/VEL) were extended to non-specialists, and a simplified care pathway for non-severe patients was implemented. Patients can thus be treated once diagnosis is confirmed (“Test and Treat” model). The study's objective was to describe the effectiveness and safety of SOF/VEL when prescribed in routine practice in France. This French multicenter, prospective, noninterventional study included adults with chronic HCV infection, treated with SOF/VEL for 12 weeks. Data on patient characteristics, fibrosis stage and HCV RNA were collected from medical charts. The primary endpoint was the proportion of patients with sustained virologic response 12 weeks post-treatment (SVR12). Secondary endpoints included safety profile, time between tests and treatment initiation, and demographics of treated patients. A total of 371 eligible patients received at least one dose of SOF/VEL: 77.4% were treated by specialists, and 22.6% by non-specialists. In the specialist group, more patients had ongoing comorbidities (29.6% vs. 7.1%), and advanced fibrosis (26.3% vs. 18.4%). In the non-specialist group, more patients reported alcohol consumption (39.3% vs. 34.4%) and drug abuse (23.8% vs. 16.4%). Among the 303 patients eligible for SVR12 analysis, SVR12 rates were nearly identical between the groups: 98.4% (95% CI: 95.84–99.36) with the specialists and 98.3% (95% CI: 91.14–99.71) with the non-specialists. Median time between positive PCR test and treatment initiation was 30 days in both groups. SOF/VEL was well tolerated, and adherence was high regardless of the prescriber. Non-specialists successfully treated chronic HCV infection with a simplified care pathway.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635576","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":"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}