Journal of Viral Hepatitis最新文献

{"title":"Association of MASLD Phenotypes With Liver Fibrosis in Hepatitis C: The Role of Cardiometabolic Risk Factors","authors":"Wesal Elgretli,&nbsp;Mohamed Shengir,&nbsp;Solomon Sasson,&nbsp;Agnihotram V. Ramanakumar,&nbsp;Felice Cinque,&nbsp;Luz Esther Ramos Ballestreros,&nbsp;Marc Deschenes,&nbsp;Phil Wong,&nbsp;Tianyan Chen,&nbsp;Nadine Kronfli,&nbsp;Sahar Saeed,&nbsp;Alexa Keeshan,&nbsp;Saniya Tandon,&nbsp;Curtis Cooper,&nbsp;Giada Sebastiani","doi":"10.1111/jvh.70004","DOIUrl":"10.1111/jvh.70004","url":null,"abstract":"<p>Steatotic liver disease is prevalent among people with hepatitis C virus (HCV). The new definition of metabolic dysfunction–associated steatotic liver disease (MASLD) emphasises the metabolic drivers of steatosis and recognises its frequent coexistence with other chronic liver diseases, including HCV. We aimed to evaluate the association of coexisting MASLD and HCV with liver fibrosis. Individuals with HCV who underwent transient elastography (TE) with associated controlled attenuation parameter (CAP) were included from two clinical centres. MASLD and significant liver fibrosis were defined as the presence of steatosis (CAP ≥ 275 dB/m) with at least one cardiometabolic risk factor, and liver stiffness measurement (LSM) ≥ 7.1 kPa measured by TE, respectively. Associated cofactors of significant liver fibrosis were determined using stepwise regression and cross-validation by LASSO models to select confounders. Among 590 participants, 31% were diagnosed with MASLD. The prevalence of significant liver fibrosis was the highest among people with MASLD (58%) followed by HCV-related steatosis (45%) and the non-steatosis group (39%). After adjusting for potential confounders, MASLD was associated with significant liver fibrosis (adjusted odds ratio [aOR] 2.29, 95% confidence interval [CI] 1.07–4.87). Furthermore, specific MASLD phenotypes including diabetes, hypertension and overweight were associated with significant liver fibrosis, with aORs of 4.76 (95% CI 2.16–10.49), 3.44 (95% CI 1.77–6.68) and 2.54 (95% CI 1.27–5.07), respectively. In conclusion, MASLD is associated with liver fibrosis in people with HCV, specifically the diabetes, overweight and hypertensive phenotypes. Beyond pursuing a virological cure, healthcare providers should prioritise managing metabolic conditions, particularly diabetes, hypertension and obesity.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046923","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":"Severe Liver-Related Outcomes in Patients With Hepatitis Delta: Results From a Multi-Ethnic Multicenter Long-Term Follow-Up Study","authors":"Arno Furquim d’Almeida,&nbsp;Erwin Ho,&nbsp;Liesbeth Govaerts,&nbsp;Peter Michielsen,&nbsp;Thomas Sersté,&nbsp;Stefan Bourgeois,&nbsp;Jean Delwaide,&nbsp;Christophe Moreno,&nbsp;Hans Orlent,&nbsp;Hans Van Vlierberghe,&nbsp;Chantal de Galocsy,&nbsp;Michael Peeters,&nbsp;Elizaveta Padalko,&nbsp;Steven Van Gucht,&nbsp;Thomas Vanwolleghem","doi":"10.1111/jvh.14060","DOIUrl":"10.1111/jvh.14060","url":null,"abstract":"<p>Hepatitis B virus (HBV)–hepatitis delta virus (HDV) coinfection is the most severe form of chronic viral hepatitis, but the factors that determine disease progression and severity are incompletely characterised. This long-term follow-up study aims to identify risk factors for severe liver-related outcomes. In this multicentre national cohort study, data from admission until the last visit between 2001 and 2023 was retrospectively collected from 162 HBV-HDV coinfected patients. The inclusion criteria were HBsAg or HBV DNA positivity, anti-HDV or HDV RNA positivity, and at least one follow-up visit. The median follow-up was 6.2 years (IQR 3.3–10.2). At baseline, 68/152 (44.7%) patients were diagnosed with advanced liver fibrosis. Forty patients (24.7%) had at least one severe liver-related outcome during follow-up. HDV viremia was detectable in 92 patients (64.3%) at last evaluation and was more frequently detectable in patients of European origin (<i>p</i> &lt; 0.001). HDV RNA-positive patients had a 4.7-fold higher risk for severe liver-related outcomes (<i>p</i> &lt; 0.001) and were more frequently diagnosed with advanced fibrosis at baseline (<i>p</i> = 0.007) compared to HDV RNA-negative patients. Multivariate analyses identified HDV RNA positivity, as well as several markers for liver disease severity, such as INR, platelet count, and advanced fibrosis at baseline, and age at admission as independent risk factors for severe liver-related outcomes. In conclusion, almost one in four HBV-HDV coinfected patients developed a severe liver-related outcome during follow-up. Several markers for liver disease severity and HDV RNA positivity were the strongest predictors for outcomes.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023794","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":"Australian Community Pharmacists' Preparedness to Offer and Discuss Hepatitis C Testing and Treatment With Pharmacy Clients: A Representative Cross-Sectional Survey","authors":"Elissa Ong,&nbsp;Ting Xia,&nbsp;Rose Laing,&nbsp;Jacqueline A. Richmond,&nbsp;Peter Higgs,&nbsp;Mark Hayes,&nbsp;Joseph S. Doyle,&nbsp;Suzanne Nielsen,&nbsp;Louisa Picco","doi":"10.1111/jvh.70001","DOIUrl":"10.1111/jvh.70001","url":null,"abstract":"<p>The World Health Organisation (WHO) has set goals to eliminate hepatitis C (HCV) as a global health threat by 2030. To meet this goal, Australia must increase testing and diagnosis, including expanding access to care through community pharmacists. This study aims to explore community pharmacists' preparedness to discuss and offer HCV testing and treatment. Australian community pharmacists from four states completed an online anonymous quantitative survey between August and October 2023. Pharmacists were asked about their experiences of, comfort discussing and willingness to host outreach HCV testing or treatment. Predictors of each outcome were examined using logistic regression. In total, 530 pharmacists participated in the study. One in five pharmacists stocked HCV medications (22%), half (48%) were willing/somewhat willing to host an outreach HCV testing and treatment team, while 36% strongly agreed/agreed they were comfortable discussing HCV testing and treatment. Willingness to host an outreach HCV team was associated with pharmacists working in rural/remote settings (95% CI: 1.04–2.35, <i>p</i> = 0.032), providing opioid agonist treatment (95% CI: 1.16–2.49, <i>p</i> = 0.006) and comfort discussing overdose prevention (95% CI: 1.31–2.80, <i>p</i> = 0.001). Pharmacists with ≥ 15 years' experience (95% CI: 0.44–0.94, <i>p</i> = 0.022) were less willing to host outreach HCV testing. Females were significantly less comfortable discussing HCV testing (95% CI: 0.45–0.98, <i>p</i> = 0.039) compared to males. This is the first Australian study to explore community pharmacists' preparedness to discuss and offer HCV testing and treatment. In light of research showing that community pharmacy models of care can help meet HCV elimination targets, ongoing engagement with pharmacists is needed to increase their preparedness to provide this care.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007724","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 Immunity and Anamnestic Response Following Hepatitis B Vaccination: A Systematic Review and Meta-Analysis","authors":"Hannah Ramrakhiani,&nbsp;Michael H. Le,&nbsp;Leslie Kam,&nbsp;Brian Nguyen,&nbsp;Yee Hui Yeo,&nbsp;Charles R. Levesley,&nbsp;Surya Gudapati,&nbsp;Scott Barnett,&nbsp;Ramsey Cheung,&nbsp;Mindie H. Nguyen","doi":"10.1111/jvh.70003","DOIUrl":"10.1111/jvh.70003","url":null,"abstract":"<div>\u0000 \u0000 <p>Using a systematic review and meta-analytic approach, this study determined the durability of HBV immunity and the prevalence of anamnestic response to a booster HBV vaccine dose in individuals previously vaccinated with a 3-dose HBV vaccine series as children or adolescents. Two researchers independently searched PubMed, Embase and Cochrane from inception to 6/1/2023 and performed data extraction. Studies that included individuals with significant comorbidities or &lt; 5 years of follow-up were excluded. Of 2517 potential studies, we analysed 91 eligible studies (193,359 individuals from 208 cohorts [some studies provided data for more than one cohort]). Median age at vaccination was 0 years (range: 0–20.00). After a median follow-up of 10.15 years (range: 5–35), 63.2% (95% CI: 59.3–67.0) retained HBV immunity. HBV immunity declined by 6.62% per follow-up year (Ptrend &lt; 0.0001). In meta-regression adjusting for vaccine type, follow-up time and geographic location, age at vaccination was significantly associated with retaining HBV immunity (adjusted odds ratio [aOR] 1.12 per year, <i>p</i> &lt; 0.0001). Anamnestic response rate (44 studies, 66 cohorts, 29,040 patients) was 90.34% (95% CI: 86.84–92.98), with highest rates in Europe and Asia, but only study setting (clinical versus community-based: aOR 2.21, <i>p</i> = 0.034) was an independent factor. HBV immunity prevalence was about 60% after 10 years following childhood vaccination. Anamnestic response rate was about 90% and varied by study setting. Testing for immunity should be considered in individuals with high exposure risk and distant vaccination history with booster as needed.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007236","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":"Evaluating Hepatitis B Screening During Pregnancy: A Study on Diagnostic Accuracy and Infection Control in Nigeria","authors":"Chinomso Joel Ukagebu,&nbsp;Jude Oluwapelumi Alao,&nbsp;Favour Oluwadara Bamigboye,&nbsp;Joel Chimezie Ukaegbu,&nbsp;Elijah Kolawole Oladipo","doi":"10.1111/jvh.70002","DOIUrl":"10.1111/jvh.70002","url":null,"abstract":"<p>Hepatitis B virus (HBV) remains a critical public health issue in low- and middle-income countries (LMICs), particularly among pregnant women in Nigeria. Routine screening using rapid diagnostic kits is common in antenatal care, yet the accuracy of these tests can vary. This study aimed to determine the seroprevalencwe of HBV among pregnant women who had previously undergone screening using rapid diagnostic kits at Obafemi Awolowo Teaching Hospital, Ilesa, Osun State, Nigeria, to assess the effectiveness of initial screening and identify any missed cases. A cross-sectional study was conducted, involving 263 pregnant women. Blood samples were tested for HBV markers (HBsAg, HBsAb, and HBcAb) using ELISA. Sociodemographic data and potential risk factors were also analysed. The study found that 7.6% of women were HBsAg positive, indicating active HBV infection, and 49.6% were susceptible to HBV. There was a significant association between higher education levels and HBV seropositivity. Employment status also correlated with HBV prevalence, with self-employed women showing higher seroprevalence. Additionally, a history of blood transfusions was linked to higher HBV seropositivity. The findings highlight the limitations of rapid diagnostic kits in detecting HBV and underscore the need for enhanced infection prevention and control measures, including confirmatory testing, robust vaccination programmes and safe delivery practices to reduce HBV transmission in high-burden regions like Nigeria.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007664","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":"DAA-PASS: A Prospective Evaluation of HCC Recurrence After Direct Acting Antiviral Therapy","authors":"Amit G. Singal,&nbsp;K. Rajender Reddy,&nbsp;Massimo Colombo,&nbsp;Heather L. Morris,&nbsp;Andrea R. Mospan,&nbsp;Roniel Cabrera,&nbsp;Robin K. Kelley,&nbsp;Ryan D. Kilpatrick,&nbsp;Franco Trevisani,&nbsp;Fabio Farinati,&nbsp;Edoardo G. Giannini,&nbsp;Neil Mehta,&nbsp;Michael W. Fried,&nbsp;Bruno Sangro,&nbsp;the DAA-PASS and ITA.LI.CA Investigators","doi":"10.1111/jvh.14056","DOIUrl":"10.1111/jvh.14056","url":null,"abstract":"<div>\u0000 \u0000 <p>Direct-acting antiviral (DAA) therapy is associated with a significant reduction in hepatocellular carcinoma (HCC) incidence among patients with cirrhosis, but data are conflicting about the risk of recurrence following DAA therapy. DAA-PASS was a prospective, pragmatic, observational study designed to estimate the risk of HCC recurrence associated with DAA therapy exposure during routine clinical care. Eligible patients were DAA treatment naive with Barcelona Clinic Liver Cancer (BCLC) stage A. Patients were followed at regular intervals for up to 24 months. To provide additional data, outcomes were compared to the Italian Liver Cancer Group (ITA.LI.CA) cohort. Of 42 patients enrolled, 24 were treated with DAA therapy. Ten HCC recurrence events were observed during the study, with 5 each in DAA-treated and DAA-untreated patients (cumulative incidences of 23 and 37 per 100 PY, respectively). The overall crude hazard ratio (HR) for HCC recurrence associated with DAA therapy was 0.6 (95% CI, 0.2–2.2). In the ITA.LI.CA cohort, HCC recurrence was observed in 193 patients during 24 months of follow-up, resulting in a cumulative incidence rate of 28 per 100 PY. Although limited by small sample size, this prospective study suggests DAA therapy is not associated with increased HCC recurrence risk among patients with a history of complete response to prior HCC therapy.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007661","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":"Immunotherapy Using HBV Vaccine Pulsed DCs and Induced T-Cells Combined Antiviral Drugs in Treatment Naive CHB Patients-A Multi-Centre Phase II Study","authors":"Yurong Gu,&nbsp;Lin Gu,&nbsp;Lubiao Chen,&nbsp;Jing Li,&nbsp;Chunhong Liao,&nbsp;Yanhua Bi,&nbsp;Zexuan Huang,&nbsp;Wei Cai,&nbsp;Jia Wei,&nbsp;Yuehua Huang","doi":"10.1111/jvh.14045","DOIUrl":"10.1111/jvh.14045","url":null,"abstract":"<div>\u0000 \u0000 <p>Dendritic cells are the most potent antigen-presenting cells in immune therapeutic approaches for chronic hepatitis B (CHB) infection. Here, we developed a clinical trial to evaluate the efficacy and safety of autologous HBV vaccine-pulsed DCs and their induced T cells (HPDCT) in CHB patients. This was a randomised, prospective, open-label, multicentre, superiority study and 309 treatment-naive CHB patients were divided into HPDCT plus nucleos(t)ide analogues (NAs) group (<i>n</i> = 84), NAs mono-therapy group (<i>n</i> = 82), HPDCT plus Peg-interferon (Peg-IFN) group (<i>n</i> = 69), Peg-IFN mono-therapy group (<i>n</i> = 74). Twelve times of HPDCT vaccinations were given intravenously, and all the patients were followed up for 72 weeks. In total, 1836 HPDCT infusions were administered with no obvious toxicity and side effect although few patients had self-limited low fever. More patients got HBsAg loss in those receiving HPDCT therapy. Patients of HPDCT plus Peg-IFN group with HBV DNA &lt; 1 × 10⁷ IU/mL at baseline exhibited earlier, stronger and longer lasting of viral response, especially HBV DNA &lt; 20 IU/mL, than those patients of Peg-IFN mono-therapy group, from week 24 till week 72 (<i>p</i> &lt; 0.05). Comparable efficacy was observed between the patients of HPDCT plus NAs group and NAs mono-therapy groups. In addition, CD25 on CD8⁺ T cells and HBV-specific CD8⁺ T cell increased significantly in patients of HPDCT combined antiviral drugs therapy. HPDCT combined with antiviral drugs was safe and able to enhance T cell immunity. Furthermore, HPDCT combined with Peg-IFN could provide an incremental benefit to patients with baseline levels of lower HBV DNA.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT01935635</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007215","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":"Heterogeneity in Risk and Implications for Hepatitis C Reinfection in People Who Inject Drugs in England","authors":"Bryn Hilton,&nbsp;Daniela De Angelis,&nbsp;Holly Mitchell,&nbsp;Ross Harris","doi":"10.1111/jvh.14052","DOIUrl":"10.1111/jvh.14052","url":null,"abstract":"<p>Chronic hepatitis C virus (HCV) infection is associated with significant morbidity, mortality and health economic burden. Over 90% of HCV cases in England occur in people who inject drugs (PWID). Current treatments for HCV are effective but do not protect against reinfection. This research characterised HCV infection and reinfection risk in PWID in England using 2011–2021 data from the annual, cross-sectional, bio-behavioural survey of PWID, Unlinked Anonymous Monitoring. Risk factors for HCV infection were explored using multivariable logistic regression. Shared frailty models for the force of infection (FOI) were used to estimate the risk of HCV infection throughout injecting career with unmeasured risk variation modelled using gamma-shaped frailty distributions. HCV reinfection rates were derived using the frailty distributions of FOI models fitted to UAM data. Infection rates were highest in the first year of injecting (24 per 100 person-years) but fell to between 5 and 8 infections per 100 person-years subsequently. The estimated average annual risks of HCV primary infection and reinfection were 10.0% and 14.2%, indicating a 42% higher risk of reinfection compared to primary infection. Even those with no a priori risk factors were predicted to have high rates of reinfection if previously infected. These findings support the recognition of primary HCV infection as an independent risk factor for reinfection in PWID and emphasise the importance of reducing high-risk behaviours to prevent HCV reinfection following treatment of primary infection. Public health policies must recognise the importance of preventing reinfection in efforts to reduce HCV infection prevalence.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007667","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 Disease and Economic Burden of HBV and HCV in Ethiopia","authors":"Alexis S. Voeller,&nbsp;Asgeir Johannessen,&nbsp;Zebideru Zewdie Abebe,&nbsp;Wegene Adugna,&nbsp;Ivane Gamkrelidze,&nbsp;Eleni Seyoum,&nbsp;Lia Tadesse Gebremedhin,&nbsp;Mirtie Getachew Meselu,&nbsp;Seblewongel Abate Nigussie,&nbsp;Asmamaw Silesh,&nbsp;Homie Razavi,&nbsp;Devin Razavi-Shearer,&nbsp;Ghion Tirsite,&nbsp;Hailemichael Desalegn","doi":"10.1111/jvh.14053","DOIUrl":"10.1111/jvh.14053","url":null,"abstract":"<p>As the second most populated country in Africa, Ethiopia needs public health measures to control diseases that impact its population. The goal of this study is to analyse disease burdens of HBV and HCV, while also highlighting their estimated associated costs for the country. A literature review and a Delphi process reflecting input of Ethiopian experts and the National Viral Hepatitis Technical Working Group were used to complement mathematical modelling to estimate HBV and HCV disease and economic burdens. Two scenarios were created for HCV: 2023 base and WHO elimination. For HBV, three scenarios were created: 2023 base, WHO elimination and universal birth dose. Using current country costs, each scenario was also examined through an economic lens. There were an estimated 7.6 million HBV infections in 2023. To impact transmission, a universal birth dose and pregnant women screening program would allow Ethiopia to vaccinate approximately 3.9 million infants annually, with a budget of $4.68 million USD, meeting the WHO prevalence elimination target (≤ 0.1% in ≤ 5-year-olds) by 2043. Ethiopia had an estimated 690,000 HCV infections in 2023. To achieve HCV elimination, the country would need to expand screening and treatment to 74,000 individuals annually with a peak budget of $12 million USD per year until 2032, decreasing to less than $2 million USD in 2035. Ethiopia can begin making steps towards elimination of HBV through expansion of birth dose vaccination. However, larger investments will be needed to scale-up treatment and diagnosis interventions for both diseases.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007244","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":"Resistance-Associated Substitution Testing Trends and Impact on HCV Treatment Outcomes in Canada: A CanHepC-CANUHC Analysis","authors":"Himain Perera,&nbsp;Haris Imsirovic,&nbsp;Gisela Macphail,&nbsp;Duncan Webster,&nbsp;Chris Fraser,&nbsp;Sergio Borgia,&nbsp;Hongqun Liu,&nbsp;Sam Lee,&nbsp;Jordan J. Feld,&nbsp;Curtis Cooper,&nbsp;the Canadian Network Undertaking Against Hepatitis C (CANUHC) Cohort Investigator Team","doi":"10.1111/jvh.14058","DOIUrl":"10.1111/jvh.14058","url":null,"abstract":"<div>\u0000 \u0000 <p>Resistance-associated substitutions (RASs) are mutations within the hepatitis C (HCV) genome that may influence the likelihood of achieving a sustained virological response (SVR) with direct acting antiviral (DAA) treatment. Clinicians conduct RAS testing to adapt treatment regimens with the intent of improving the likelihood of cure. The Canadian Network Undertaking against Hepatitis C (CANUHC) prospective cohort consists of chronic HCV patients enrolled between 2015 and 2023 across 17 Canadian sites. Utilisation of RAS testing was assessed across demographics, clinical characteristics and years. SVR was described for the overall cohort and compared across populations of patients with historically negative predictors of SVR. The detection of key RASs and how this information influenced DAA selection were assessed. 2434 patients were identified with information on RAS testing. 98.3% achieved SVR. Out of the 227 patients tested for RAS, 147 (64.8%) had any detected RAS, and 84 (37.0%) had an NS5A RAS. The proportion of patients with SVR did not differ between RAS-tested (98.3%) and non-tested patients (98.3%; <i>p</i> = 0.99). SVR in those with an NS5a RAS was similar (98.6%) to the overall SVR proportion. Proportions with SVR did not differ between those with and without RAS testing in key subgroups (genotype 1a, genotype 3, prior treatment, cirrhosis). The specific DAA regimen and the addition of ribavirin were not associated with SVR outcome. RAS testing has a minimal influence on antiviral treatment selection. Going forward, there is a reduced role for RAS testing in most clinical scenarios.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055966","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}