Journal of Viral Hepatitis最新文献

{"title":"Virologic Response to Antiviral Therapy in Chronic Hepatitis B Patients With High Viral Load: A Real-World Cohort Study","authors":"Siwei Zheng,&nbsp;Xueyan Li,&nbsp;Hongli Liu,&nbsp;Tianhao Mao,&nbsp;You Ge,&nbsp;Wenjing Ji,&nbsp;Xixuan Wang,&nbsp;Yijun Bao,&nbsp;Yu Zhang,&nbsp;Anling Zhou,&nbsp;Qunzeng Danzeng,&nbsp;Jialuo Wang,&nbsp;Feng Yang,&nbsp;Qingfang Xiong,&nbsp;Yongfeng Yang","doi":"10.1111/jvh.70226","DOIUrl":"10.1111/jvh.70226","url":null,"abstract":"<div>\u0000 \u0000 <p>Current guidelines for chronic hepatitis B (CHB) have progressively expanded antiviral treatment indications, with age &gt; 30 years increasingly being incorporated as an important criterion. However, real-world evidence regarding treatment outcomes in this expanded population remains limited. This study evaluated the 48-week treatment response and its independent predictors in treatment-naïve CHB patients aged &gt; 30 years with a high baseline viral load. This retrospective study included 808 treatment-naïve CHB patients aged &gt; 30 years with baseline HBV DNA ≥ 2000 IU/mL who received first-line nucleos(t)ide analogue (NA) monotherapy. Patients were classified into moderately high (MH; ≥ 2 × 10³ to &lt; 1 × 10⁷ IU/mL) and extremely high (EH; ≥ 1 × 10⁷ IU/mL) viral load groups. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to adjust for baseline imbalance. At week 48, the overall virological response (VR) rate was 90.0% (727/808). Among HBeAg-positive patients at baseline, the HBeAg seroclearance and seroconversion rates were 14.0% (59/422) and 11.8% (50/422), respectively. Compared with the MH group, the EH group had significantly lower rates of VR (81.8% vs. 95.5%, <i>p</i> &lt; 0.001), HBeAg seroclearance (9.4% vs. 22.6%, <i>p</i> &lt; 0.001) and HBeAg seroconversion (7.2% vs. 20.5%, <i>p</i> &lt; 0.001). Multivariable Cox regression analysis showed that ALT ≥ 5 × ULN was independently associated with a higher likelihood of VR, whereas HBeAg positivity and HBV DNA ≥ 1 × 10⁷ IU/mL were independently associated with a lower likelihood of VR. These associations remained robust after PSM and IPTW adjustment. First-line NA therapy achieved a favourable 48-week VR in CHB patients aged &gt; 30 years with a high viral load. However, HBeAg positivity and extremely high viral load were associated with suboptimal response, supporting intensified monitoring and individualised management.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808935","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":"Peripheral Biomarkers in Chronic Hepatitis D Infection: A Review","authors":"Zillah Cargill,&nbsp;James Lok,&nbsp;Geoffrey Dusheiko,&nbsp;Ivana Carey","doi":"10.1111/jvh.70225","DOIUrl":"https://doi.org/10.1111/jvh.70225","url":null,"abstract":"<div>\u0000 \u0000 <p>Chronic hepatitis D represents the most severe form of viral hepatitis and is associated with higher rates of advanced fibrosis, cirrhosis and hepatocellular carcinoma than hepatitis B monoinfection. It is caused by the hepatitis D virus (HDV), a defective RNA virus that requires co-infection with hepatitis B (HBV) for hepatocyte entry and propagation. Accurate prediction of liver disease sequelae and treatment response using currently available serological biomarkers remains challenging. This article reviews peripheral biomarkers in HDV, including novel biomarkers of HBV activity, exploring their potential clinical utility and areas for future development. Peripheral biomarkers capable of risk stratifying patients with HDV, monitoring or predicting treatment response and elucidating the natural history of infection (including the complex relationship with HBV), would enable individualised care and early identification of those at greater risk of developing advanced liver disease. Establishing the role of these biomarkers in larger, ethnically diverse populations both on existing treatments and in the context of emerging antiviral therapies will be imperative going forward.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784004","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":"A New Nomogram for Mortality Prediction Within 5 Years in Portal Vein Thrombosis due to Hepatitis B-Related Cirrhosis","authors":"Yang Zhou,&nbsp;Feixiang Xiong,&nbsp;Jialiang Chen,&nbsp;Xiaoli Liu,&nbsp;Peipei Meng,&nbsp;Tong Wu,&nbsp;Hao Yu,&nbsp;Xiaomin Ji,&nbsp;Yuyong Jiang,&nbsp;Yixin Hou","doi":"10.1111/jvh.70220","DOIUrl":"https://doi.org/10.1111/jvh.70220","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aims to develop a nomogram model intended for predicting long-term mortality in patients suffering from hepatitis B-related cirrhosis associated with Portal vein thrombosis (PVT). A total of 961 patients were recruited from January 2015 to December 2023, forming the training cohort. We analysed independent risk factors affecting 5-year mortality through COX regression, from which we constructed a nomogram. To assess the nomogram's utility, we employed the receiver operating characteristic (ROC) curve, C-index, calibration curves, and decision curve analysis (DCA). The independent prognostic factors retained in the final model for patients with hepatitis B-related cirrhosis complicated by PVT included age (HR = 1.09, 95% CI: 1.06–1.11; <i>p</i> &lt; 0.001), leukocyte count (WBC) (HR = 1.09, 95% CI: 1.03–1.17; <i>p</i> = 0.002), and the neutrophil-to-lymphocyte ratio (NLR) (HR = 1.29, 95% CI: 1.22–1.35; <i>p</i> &lt; 0.001), along with serum sodium (HR = 0.94, 95% CI: 0.90–0.98; <i>p</i> = 0.005). The AUROC values for the nomogram were 0.906 (95% CI: 0.891–0.921) in the training cohort and 0.910 (95% CI: 0.885–0.927) in the validation cohort, demonstrating improved performance and discriminatory ability compared to current models, including CTP and MELD scores. Age, leukocyte count (WBC), NLR, and serum sodium emerged as independent risk factors impacting prognosis for patients with hepatitis B cirrhosis and PVT within 5 years. The nomogram developed in this research holds significant potential for accurately predicting the outcomes of these patients within 5 years.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148783812","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":"Risk of Liver Cancer From Major Causes Compared to Smoking and Lung Cancer: A Systematic Review and Meta-Analysis","authors":"Carolyn Wallace,&nbsp;Devin Razavi-Shearer,&nbsp;Samantha Hall,&nbsp;Tarik Asselah,&nbsp;Cary James,&nbsp;Loreta A. Kondili,&nbsp;Shyamasundaran Kottilil,&nbsp;Daniel Low-Beer,&nbsp;Poonam Mathur,&nbsp;Junko Tanaka,&nbsp;Harrys A. Torres,&nbsp;Homie Razavi","doi":"10.1111/jvh.70222","DOIUrl":"10.1111/jvh.70222","url":null,"abstract":"<p>Liver cancer is the second leading cause of premature cancer mortality globally, whose main causes—HBV, HCV, MASH and alcohol use—are preventable. Viral hepatitis' carcinogenicity is not as well-known as the risk of lung cancer from smoking, leading to rising rates of liver cancer worldwide. The aim of this study was to compare the risk of liver cancer in HBV, HCV, HDV, MASH and alcohol consumption with the better-known risk of lung cancer associated with smoking. We extracted the relative risk of liver cancer from HBV, HCV, HDV, MASH, and alcohol use and the relative risk of lung cancer from smoking from previous studies. We included cohort, case–control and nested case–control studies published as original articles. Odds ratios for each factor were pooled globally and by region to test for significant differences. One hundred and twenty-six studies with 86,097,714 participants were included. Relative to the risk of lung cancer and currently smoking (OR 6.0), HBV (OR 15.2, <i>p</i> &lt; 0.001), HCV (OR 12.8, <i>p</i> &lt; 0.01) and HDV (OR 23.5, <i>p</i> &lt; 0.01) were significantly associated with a higher risk of liver cancer, while MASLD (OR 2.6, <i>p</i> &lt; 0.01) and alcohol use (OR 2.4, <i>p</i> &lt; 0.001) were significantly associated with a lower risk of liver cancer. There was no statistically significant difference in liver cancer risk across regions. These findings highlight that viral hepatitis is a carcinogenic infectious disease. Better integration of HCC surveillance within the management of viral hepatitis is critical.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759798","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":"Geospatial Discrepancy of Chronic Hepatitis B and Hepatitis D Testing in Alberta: A Population-Based Spatial Analysis","authors":"Bryce Tkachuk,&nbsp;Isabelle Couloigner,&nbsp;Carla S. Coffin,&nbsp;Jason Jiang,&nbsp;Stefania Bertazzon,&nbsp;Abdel-Aziz Shaheen","doi":"10.1111/jvh.70223","DOIUrl":"https://doi.org/10.1111/jvh.70223","url":null,"abstract":"<p>Chronic hepatitis B (CHB) and hepatitis D virus (HDV) coinfection are major causes of cirrhosis and hepatocellular carcinoma. The geographic distribution of CHB and alignment of anti-HDV testing with CHB burden remain poorly defined. We aimed to examine if anti-HDV testing and seropositivity align with areas of highest CHB burden. Adults with CHB (2014–2022) were identified using a validated serologic algorithm in the provincial laboratory database capturing HBV/HDV serology. Cases were geolocated to Aggregate Dissemination Areas (ADAs), linked to Alberta Health Services zones and rural–urban continuum levels. Age- and sex-standardized CHB prevalence was calculated per ADA using the 2016 Canadian Census. Descriptive mapping, global spatial autocorrelation and local hotspot analysis were used to assess spatial clustering. Among 8317 persons with CHB, the provincial age- and sex-standardized prevalence was 1.70 per 1000 population (95% CI, 1.66–1.74). Prevalence ranged from 2.15 per 1000 in metropolitan areas to 0.40 per 1000 in remote regions and was higher in Calgary than Edmonton (2.53 vs. 1.73 per 1000). Overall, 17.5% of CHB patients were tested for anti-HDV, and 4.1% of those tested were anti-HDV positive. CHB prevalence hotspots were concentrated in metropolitan ADAs, whereas hotspots of anti-HDV testing and positivity showed only partial overlap with these high-burden areas. CHB burden in Alberta is geographically clustered, particularly within specific neighbourhoods of metropolitan cities, whereas anti-HDV testing remains infrequent and only partially aligned with high-burden areas. Reflex or systematic anti-HDV testing, paired with geographically informed outreach, may improve case detection.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753671","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":"Attendance Among People With Hepatitis B in UK Secondary Care: A Scoping Review","authors":"Emma Victoria Shiel,&nbsp;Bini George,&nbsp;Arpana Verma,&nbsp;Norina Gasteiger","doi":"10.1111/jvh.70221","DOIUrl":"10.1111/jvh.70221","url":null,"abstract":"<p>Chronic Hepatitis B disease requires lifelong monitoring to prevent complications such as cirrhosis and hepatocellular carcinoma. Despite structured care pathways, non-attendance within UK secondary care remains challenging. This scoping review aimed to synthesise existing evidence on factors influencing non-attendance at secondary care appointments and strategies to improve appointment adherence among people living with Chronic Hepatitis B. Eligibility Criteria: Peer-reviewed sources examining adults with Hepatitis B attendance at UK secondary care services. Grey literature was excluded. Sources of Evidence: Searches were performed in CINAHL Ultimate, Medline, Embase, Scopus and APA PsycINFO. Data were charted using a structured data extraction form and synthesised narratively. Eleven studies met the inclusion criteria. Identified barriers included patient-related factors (e.g., limited health literacy, stigmatisation, competing priorities), system-level challenges (e.g., appointment scheduling and accessibility) and cultural or language barriers. Psychological factors, including fear of diagnosis and treatment side effects, were also reported. Reported strategies included patient education, culturally tailored interventions, reminder systems (e.g., SMS and telephone calls) and integrated care models involving community outreach. Non-attendance among people with chronic Hepatitis B in secondary care is influenced by a complex interplay of personal, social and systemic factors. Interventions that address multiple barriers, particularly those that incorporate culturally sensitive approaches and reminder systems, may improve engagement. Further research is needed to co-design and evaluate interventions with affected communities.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712390","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":"Characterising Hepatitis D Virus in the UK From 2011 to 2021","authors":"R. Simmons,&nbsp;S. Ijaz,&nbsp;R. Jackson,&nbsp;K. Jack,&nbsp;R. Mulongeni,&nbsp;R. Raghu,&nbsp;A. Riddell,&nbsp;A. Elsharkawy,&nbsp;A. Uriel,&nbsp;A. Koffas,&nbsp;A. Chaika,&nbsp;A. Lawson,&nbsp;A. Cole,&nbsp;A. McEwan,&nbsp;A. Brown,&nbsp;B. Stone,&nbsp;C. Levick,&nbsp;D. Byrne,&nbsp;D. Forton,&nbsp;D. MacDonald,&nbsp;D. Forde,&nbsp;E. Nastouli,&nbsp;E. Barnes,&nbsp;E. Sumner,&nbsp;E. Page,&nbsp;I. Carey,&nbsp;F. J. Vilar,&nbsp;J. Maggs,&nbsp;J. Collier,&nbsp;J. Shepherd,&nbsp;K. Agarwal,&nbsp;K. Bicknell,&nbsp;K. Ala,&nbsp;K. Dear,&nbsp;L. Ratcliffe,&nbsp;M. Bruce,&nbsp;H. Zhang,&nbsp;L. Rivett,&nbsp;M. Maes,&nbsp;M. Ankcorn,&nbsp;M. Aldersley,&nbsp;M. Prince,&nbsp;M. Lemoine,&nbsp;M. Foxton,&nbsp;M. Wright,&nbsp;M. Cramp,&nbsp;M. Wiselka,&nbsp;N. Easom,&nbsp;P. Richardson,&nbsp;R. Gunson,&nbsp;R. Herbert,&nbsp;R. Blackwell,&nbsp;R. Jelley,&nbsp;R. Aspinall,&nbsp;R. Simpson,&nbsp;R. Clewes,&nbsp;S. Ahmad,&nbsp;S. Mcpherson,&nbsp;S. Ryder,&nbsp;S. Verma,&nbsp;T. Lampejo,&nbsp;V. Sathyanarayana,&nbsp;W. Gelson,&nbsp;D. Leeman,&nbsp;M. Desai,&nbsp;S. Mandal,&nbsp;P. T. Kennedy,&nbsp;W. L. Irving","doi":"10.1111/jvh.70205","DOIUrl":"10.1111/jvh.70205","url":null,"abstract":"<p>Little is known about hepatitis B virus (HBV) and Hepatitis D virus (HDV) coinfection in the UK. HDV screening is recommended among all individuals with HBV, with coinfection associated with increased disease progression. Using data on HDV testing, shared by 11 laboratories in the UK who reported undertaking HDV testing, and national testing data for HBV we established a cohort of individuals tested for HDV, investigating testing pathways, describing characteristics and outcomes of those HDV-RNA positive to inform targeted interventions for testing, diagnosis and linkage to care. Demographic information, clinical assessments, treatment and recent laboratory results from NHS trusts, and through linkage to national healthcare datasets was collected for HDV-RNA positive individuals. Between 2011 and 2021, 42% of individuals newly diagnosed with HBV in England were linked to an HDV test. Anti-HDV positivity was 5.0%, 55.8% were HDV-RNA tested and 45.7% were ever HDV-RNA positive. HDV-RNA positivity in the absence of an anti-HDV result was 6.4%. Among individuals who were HDV-RNA positive, 94.3% were non-UK born, with 24 different primary languages reported, 49% had evidence of treatment, and 48% had evidence of cirrhosis. 10% had died of which 58.4% died of liver disease. In conclusion, our findings indicate that HDV testing in HBV positive individuals in the UK is sub-optimal against testing guidelines, including RNA testing among those who are anti-HDV positive. Considerable work is needed to improve the patient care pathway, to ensure patients are appropriately diagnosed, linked and retained in care, with adequate access to treatment.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701652","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 Hepatitis B Virus Infection in Cameroon: A Systematic Review and Meta-Analysis","authors":"Iya Maliki,&nbsp;Edward J. D. Webb,&nbsp;Rose Armelle Ada,&nbsp;Bryony Dawkins,&nbsp;Aaron G. Lim","doi":"10.1111/jvh.70219","DOIUrl":"10.1111/jvh.70219","url":null,"abstract":"<p>Chronic hepatitis B virus (HBV) infection is a global public health problem, and many regions of Sub-Saharan Africa are disproportionately affected, including Cameroon, where prevalence has previously been shown to be high. This study aimed to provide up-to-date estimates of HBV prevalence in Cameroon. We searched Medline, Global Health, Embase, Web of Science, Cochrane Library, Africa Index Medicus and the Journal of Health Science and Disease at the University of Yaounde. We included studies reporting HBV surface antigen (HBsAg) prevalence in the general population and subpopulations. A random-effects meta-analysis was used to generate pooled estimates of HBsAg prevalence, overall and for population subgroups including those considered at relatively higher-risk and relatively lower-risk of HBV infection. Heterogeneity was assessed using the index of heterogeneity (<i>I</i>^<i>2</i>). Quality was assessed using the Joanna Briggs Institute critical appraisal tool. Out of 1236 records, 92 papers with 100 studies were included in the meta-analysis. Overall prevalence of HBV in Cameroon was 9.98% (95% confidence interval [CI] 9.00–11.02) with high heterogeneity (<i>I</i>^<i>2</i> <i>= 98.10%</i>)<i>.</i> The prevalences for relatively lower-risk and higher-risk populations were8.94% (95% CI 7.84–10.11) and 12.70% (95% CI 10.28–15.32), respectively. In subgroup analyses, we found that sex, geographical area (regions), population risk groups and study design were the main sources of heterogeneity. Overall, HBV prevalence remains high in Cameroon. Our findings suggest an urgent need for health interventions to halt the spread of the disease, with particular attention needed for males and regions with the highest prevalence.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673680","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":"Validation of a Point-Of-Care Ultrasound for Hepatitis Among Front-Line Healthcare Workers Managing Chronic Hepatitis B Virus Infection in Zambia","authors":"Costanza Bertoni,&nbsp;Annie Kanunga,&nbsp;Edford Sinkala,&nbsp;Enock Syabbalo,&nbsp;Helen Chitundu,&nbsp;Alick Chikwezi,&nbsp;Carolyn Chibundi,&nbsp;Guy K. Muula,&nbsp;Samuel Bosomprah,&nbsp;Nicolò Capra,&nbsp;Riccardo Lolatto,&nbsp;Giulia Morsica,&nbsp;Antonella Castagna,&nbsp;Claudia Wallrauch,&nbsp;Tom Heller,&nbsp;Michael J. Vinikoor","doi":"10.1111/jvh.70216","DOIUrl":"10.1111/jvh.70216","url":null,"abstract":"<p>To close gaps in implementing care of people with hepatitis B virus (HBV) infection in resource-limited settings, we evaluated the accuracy of a novel liver point-of-care ultrasound (POCUS) protocol for hepatitis (PUSH) among front-line non-radiology healthcare workers in Zambia. At University Teaching Hospital in Lusaka, Zambia, from March to June 2024, we trained four nurses and six physicians with experience in HBV management, but not in ultrasound (US), in the PUSH protocol, which includes visualizing the liver in three windows (epigastric, subcostal and right transcostal) to identify cirrhosis-suggestive features and liver lesions suspicious for hepatocellular carcinoma (HCC). Then, consecutive adult participants with chronic hepatitis B (PWHB) alone or HBV/HIV coinfection underwent PUSH with operators blinded to clinical data. We evaluated the accuracy of PUSH for significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard test (RST) and for liver lesions that were possible HCC using a comprehensive abdominal ultrasound by an experienced radiographer as the RST. Nonparametric analysis of the receiver operating curve (ROC) for PUSH was adjusted for operator type (doctor vs. nurse), sex and HIV status. Among 197 PWHBs analysed, 69.5% were taking HBV antivirals and 27.9% had HBV/HIV. According to RSTs, 17.7% of PWHBs had significant fibrosis, 11.6% had cirrhosis and 3.5% had liver lesions. PUSH had low accuracy for significant fibrosis, with sensitivity of 8.3% (17.5–41.4), specificity of 100.0% (96.1–100) and an area under the curve (AUROC) of 0.54 (0.43–0.65), moderate accuracy for cirrhosis, with sensitivity of 60.9% (38.5–80.3), specificity of 97.7% (94.2–99.4) and AUROC of 0.79 (0.69–0.89), and higher accuracy for liver lesions, with 85.7% (42.1–99.6) sensitivity, 98.4% (95.5–99.7) specificity, AUROC of 0.92 (0.78–1.00). After an expedited training, front-line nurses and physicians treating HBV in Zambia were able to use PUSH to diagnose cirrhosis with moderate accuracy and liver lesions with high accuracy, although confidence intervals around performance estimates were wide. Liver POCUS including PUSH may be useful in HBV management when laboratory systems and TE are lacking.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669157","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 Chronic Hepatitis D Virus Infection on Health-Related Quality of Life and Fatigue: A Real-World International Study","authors":"P. Lampertico,&nbsp;R. G. Gish,&nbsp;N. Reau,&nbsp;H. Wedemeyer,&nbsp;M. Buti,&nbsp;A. Kaushik,&nbsp;A. Yehoshua,&nbsp;C. Burk,&nbsp;L. Mirams,&nbsp;H. Ellis,&nbsp;T. Taylor-Whiteley,&nbsp;M. Rock","doi":"10.1111/jvh.70193","DOIUrl":"https://doi.org/10.1111/jvh.70193","url":null,"abstract":"<p>As little is known about the disease burden of chronic hepatitis D virus (HDV) infection, this study examined health-related quality of life (HRQoL) and fatigue at different disease stages. This was a real-world quantitative cross-sectional survey of patients in Germany, Italy, Spain and the USA. Patients were recruited via their treating physicians. Patients who had received bulevirtide for hepatitis B or treatment licensed for HDV were excluded. Of 211 patients, 41% were noncirrhotic (<i>F0–F3</i>); 20% had liver cirrhosis with normal function (<i>compensated</i>); 20% had liver cirrhosis (<i>F4</i>) with impaired function (<i>decompensated</i>); 19% had hepatocellular carcinoma (<i>HCC</i>). Mean (standard deviation; SD) age was 54.5 (11.5) years, 75% were male. ANOVA showed a significant decrease (indicating poorer HRQoL) in EQ-5D-3L visual analogue scale (VAS) scores and index values with worsening disease stage and increasing severity (all <i>p</i> &lt; 0.0001). All domain scores of the Hepatitis Quality of Life Questionnaire v2 (except positive wellbeing) worsened with progressing disease and increasing symptom severity (all <i>p</i> ≤ 0.0001). Mean Fatigue Severity Scale (FSS) total scores also increased, indicating greater fatigue, with worsening of disease and increasing symptom severity (both <i>p</i> &lt; 0.0001). HDV infection significantly impacts patients' HRQoL and fatigue, particularly for patients at later disease stages. Treatments that slow disease progression, reducing the burden of HDV infection, are needed.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647879","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}