Journal of Viral Hepatitis最新文献

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

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

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

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

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

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

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

{"title":"Prospective Evaluation of Blood Borne Virus Testing in Custody Suites in North-East England","authors":"Danielle Rayner,&nbsp;Francesca McCullough,&nbsp;Kate McQue,&nbsp;Kerry Jones,&nbsp;Caroline Allsop,&nbsp;Jenna Bell,&nbsp;Carolyn Miller,&nbsp;Stuart McPherson","doi":"10.1111/jvh.70042","DOIUrl":"https://doi.org/10.1111/jvh.70042","url":null,"abstract":"<p>Drug-related crime is a common reason for arrest. Therefore, some arrested individuals are at risk of hepatitis C virus infection (HCV). We present the outcomes of a blood borne virus (BBV) testing programme in custody suites in North-East England. Individuals reviewed in healthcare departments of three custody suites were offered dry blood spot BBV testing for HCV, hepatitis B (HBV) and human immunodeficiency virus (HIV) between July 2021 and June 2024. Data were collected prospectively on numbers tested, virology results and treatment outcomes. In total, 582 had BBV testing (508 [87%] valid HCV antibody and HCV RNA tests). Overall, 13% (64) had a detectable HCV antibody and 6% (31) had detectable HCV RNA indicating active HCV infection. Of these, 12 (39% of HCV RNA positive; 2.3% of all tested) were newly identified infections. Twenty-four individuals (77%) commenced antiviral treatment. Six individuals did not start antiviral treatment because of non-engagement, and one is in treatment workup. Of the 33 HCV antibody–positive, but RNA-negative individuals, 20 (61%) had previous antiviral treatment and achieved SVR, nine (27%) were thought to have spontaneously cleared the infection and four (12%) were on treatment at the time of testing. There were no cases of HBV or HIV identified. Dry blood spot testing for BBVs in custody suites is feasible and identifies a high proportion with active HCV infection, with the majority commencing antiviral treatment. Viral hepatitis services should consider expanding BBV testing to custody suites to help work towards HCV elimination.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244568","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":"Scoping Review on Strategies for Safe Nucleot(s)ide Analogue Discontinuation and Optimising Functional Cure in Chronic Hepatitis B","authors":"Soe Thiha Maung,&nbsp;Roongruedee Chaiteerakij","doi":"10.1111/jvh.70040","DOIUrl":"https://doi.org/10.1111/jvh.70040","url":null,"abstract":"<div>\u0000 \u0000 <p>Chronic hepatitis B (CHB) remains a global health challenge, contributing to significant morbidity and mortality. While long-term nucleos(t)ide analogue (NA) therapy effectively suppresses viral replication, achieving a functional cure remains rare. Current treatment guidelines primarily recommend indefinite therapy. However, long-term NA use poses many challenges, prompting interest in finite therapy. Recent studies suggest that carefully selected patients may safely discontinue NAs, leading to a functional cure in some cases. This review evaluates the latest evidence on NA discontinuation, highlighting key factors influencing outcomes. This review synthesises established and emerging evidence on NA discontinuation in CHB. It explores early studies that identified quantitative HBsAg (qHBsAg) as a predictor of sustained response and HBsAg seroclearance, followed by systematic reviews and meta-analyses reinforcing finite therapy as a feasible approach. Advances in predictive modelling, incorporating biomarkers, have refined patient selection for safe NA withdrawal. Additionally, this review assesses the risks associated with NA discontinuation, highlighting the importance of identifying high-risk patients for hepatic decompensation. Ethnicity-specific qHBsAg cut-offs are also discussed, recognising variations in treatment response between Asian and Caucasian populations. Finite NA therapy is emerging as a viable approach for achieving functional cure. Future strategies should integrate liver fibrosis assessment to enhance patient selection before NA discontinuation. Optimising re-treatment approaches requires balancing timing, immune response, and qHBsAg kinetics to maximise HBsAg seroclearance. Clinical perspectives on NA discontinuation remain a key research priority, necessitating standardised guidelines and improved post-NA monitoring strategies to ensure safe and effective finite therapy in CHB management.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220296","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":"COVID-19 and Liver Injury, Beyond the First Pandemic Waves: Clinical and Immune-Virological Features","authors":"Luca Foroghi Biland,&nbsp;Andrea Di Lorenzo,&nbsp;Francesco De Maria,&nbsp;Gianmarco Muratore,&nbsp;Mirko Compagno,&nbsp;Laura Campogiani,&nbsp;Luigi Coppola,&nbsp;Elisabetta Teti,&nbsp;Vincenzo Malagnino,&nbsp;Marco Iannetta,&nbsp;Loredana Sarmati","doi":"10.1111/jvh.70039","DOIUrl":"https://doi.org/10.1111/jvh.70039","url":null,"abstract":"<p>A liver involvement in Coronavirus disease 19 (COVID-19) has been frequently observed in patients hospitalised for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection during 2020; in such cases, the clinical and prognostic relevance of hepatocellular damage has been widely acknowledged. On the other hand, there is less extensive evidence of liver injury (LI) in the subsequent waves of the COVID-19 pandemic. The aim of this study was to assess the prevalence of LI and to determine the clinical, biochemical, and immune-virologic characteristics associated with its development in SARS-CoV-2-positive patients hospitalised in 2021–2022. This single-centre retrospective study included 455 patients with confirmed SARS-CoV-2 infection and respiratory failure. LI was defined by the detection of transaminase levels exceeding three times the upper limit of normality (ULN) and was further classified as early or late liver injury based on whether the peak transaminase value occurred within or after 7 days from hospital admission. LI was found in 17.6% (80/455) of the overall cohort, while early liver injury (ELI) and late liver injury (LLI) were detected in 10.4% and 11.5%, respectively. LI was associated with younger age, elevated inflammatory and tissue damage markers, with the presence of chronic liver disease (CLD), and with the use of interleukin-6 (IL-6) inhibitors. Patients with LI had a higher probability of severe COVID-19, transfer to intensive care unit, and in-hospital death than those without. In multivariable analysis, younger age, administration of IL-6 inhibitors, and the presence of higher gammaglutamyl transferase (GGT) levels were independently related to the development of overall LI, whereas in-hospital mortality was independently correlated with the occurrence of LLI. The occurrence of hepatocellular damage therefore has been associated with a pro-inflammatory profile and with worse overall outcomes but not with increased likelihood of liver failure or liver-related mortality.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213865","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}