Chiara Noviello, Maurizio Aricò, Francesco Livio Scazzi, Giacomo Riformato, Onofrio Florio, Alessandro Furio, Angela Maria Vittoria Larocca, Claudia Palmieri, Stefano Manzi, Michele Alberto Cantalice, Silvio Tafuri, Pasquale Stefanizzi
{"title":"Long-Term Persistence of Hepatitis A Virus Immunity in Healthcare Workers Upto 25 Years After Vaccination.","authors":"Chiara Noviello, Maurizio Aricò, Francesco Livio Scazzi, Giacomo Riformato, Onofrio Florio, Alessandro Furio, Angela Maria Vittoria Larocca, Claudia Palmieri, Stefano Manzi, Michele Alberto Cantalice, Silvio Tafuri, Pasquale Stefanizzi","doi":"10.1111/jvh.70187","DOIUrl":"10.1111/jvh.70187","url":null,"abstract":"<p><p>Hepatitis A virus (HAV) remains globally endemic, particularly in populations with limited sanitation and poses risks to travellers and healthcare personnel. Although vaccination provides long-term protection, data on the duration of immunity in occupationally exposed groups are limited. We conducted a prospective cohort study among healthcare personnel and medical students vaccinated with either a monovalent HAV vaccine (Havrix, Avaxim) or a combined HAV/HBV vaccine (Twinrix) between 1996 and 2003 at Bari University Hospital, Italy. Vaccination records were verified, and serum anti-HAV IgG concentrations were quantified using CMIA (ARCHITECT HAVAb-IgG). Statistical analyses included Student's t-test, χ<sup>2</sup> test and logistic regression (STATA MP 11). A total of 334 participants were included (167 per group; mean age 31 vs. 36 years). After a median of 23 years since vaccination, seroprotection rates were 94.6% for the monovalent and 97.0% for the bivalent vaccine groups (p = 0.28). Mean anti-HAV IgG concentrations were significantly higher in the bivalent vaccine group (10.9 ± 4.6 IU/mL) than in the monovalent group (8.3 ± 4.6 IU/mL; p < 0.001). No associations were observed with sex or behavioural factors, and younger age was the only independent predictor of higher antibody levels (β = 0.32; 95% CI, 0.10-0.43; p < 0.001). These findings demonstrate that protective HAV antibody levels persist for more than two decades after vaccination. Both monovalent and bivalent vaccines confer durable immunity, supporting the continued inclusion of HAV vaccination in national immunisation programs and occupational health strategies.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 6","pages":"e70187"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Framework for Emergency Department-Integrated Hepatitis C Test-and-Treat in the United States.","authors":"Saeed S Graham","doi":"10.1111/jvh.70178","DOIUrl":"10.1111/jvh.70178","url":null,"abstract":"<p><p>Despite the availability of curative, direct-acting antiviral therapy, hepatitis C virus elimination remains incomplete. Losses across the care cascade continue to limit impact, from initial diagnosis to sustained virologic response. Fewer than 1/3 of individuals ultimately achieve cure. These gaps reflect a delivery system that does not align with the population most affected, many of whom have inconsistent engagement with outpatient care. The emergency department is critical, but underused point of contact, where the burden of undiagnosed and untreated infection is high. This manuscript presents a practical framework for integrating HCV testing and treatment into emergency care within a new United States. It focuses on five domains. Point of care RNA testing allows confirmation of infection during the encounter, reducing delays that contribute to loss to follow up. Treatment initiation is simplified through standardised eligibility criteria and use of pan genomic regimens supported by electronic decision support. A focused safety screen addresses key exclusions, including hepatitis B coinfection, advanced liver disease, renal impairment, and relevant drug interactions. Policy and financial barriers are examined, including prior authorisation requirements, variation of Medicaid coverage, and access to discount pricing programmes. Post treatment follow up is restructured through decentralised approaches such as dried blood spot testing, telemedicine, and linkage to harm reduction services. Implementation will vary across institutions and regions. Regulatory requirements, payer policies, and staffing models remain important constraints. These challenges identify areas for targeted policy reform and prospective study. The emergency department is not traditionally designed for chronic disease management. However, for a curable infection concentrated among patients who rely on episodic care, it may represent the most effective point of intervention.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 6","pages":"e70178"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775168","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}
Yusuf Yilmaz, Ming-Lung Yu, Khalid Alswat, Mohamed El-Kassas, Maria Buti Ferret, Georgios Papatheodoridis, Marlen Fernandez, Yuichiro Eguchi, Ajay Duseja, Çaglayan Keklikkiran, Saeed Hamid, Wah Kheong Chan, Stuart C Gordon, Gamal Esmat, Vasily Isakov, Stuart Roberts, Nahum Méndez-Sánchez, Jian Gao Fan, Manuel Romero Gomez, Jacob George, Ashwani K Singal, Aijaz Ahmed, Brian Lam, Fatema Nader, Linda Henry, Maria Stepanova, Saleh AlQahtani, Zobair M Younossi
{"title":"Impact of Fatigue on Patient-Reported Outcomes and Work Productivity in Chronic Hepatitis B and C: Insights From a Multinational Registry Study.","authors":"Yusuf Yilmaz, Ming-Lung Yu, Khalid Alswat, Mohamed El-Kassas, Maria Buti Ferret, Georgios Papatheodoridis, Marlen Fernandez, Yuichiro Eguchi, Ajay Duseja, Çaglayan Keklikkiran, Saeed Hamid, Wah Kheong Chan, Stuart C Gordon, Gamal Esmat, Vasily Isakov, Stuart Roberts, Nahum Méndez-Sánchez, Jian Gao Fan, Manuel Romero Gomez, Jacob George, Ashwani K Singal, Aijaz Ahmed, Brian Lam, Fatema Nader, Linda Henry, Maria Stepanova, Saleh AlQahtani, Zobair M Younossi","doi":"10.1111/jvh.70188","DOIUrl":"10.1111/jvh.70188","url":null,"abstract":"<p><p>Fatigue in chronic viral hepatitis may be associated with decreased health-related quality of life and other patient-reported outcomes (PROs). We evaluated the relationship between fatigue and PROs in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Patients with CHB and CHC enrolled in the Global Liver Registry completed PRO instruments: FACIT-F, CLDQ (for CHB), CLDQ-HCV (for CHC), and WPAI:SHP. Fatigue was defined as FACIT-F Fatigue Scale (FS) score < 30 (scale range: 0-52). Among 2888 patients from 14 countries, 1561 had CHB (mean age 47 ± 13 years; 60% male; 13% advanced fibrosis; 13% depression; 17% fatigue) and 1327 had CHC (50 ± 13 years; 47% male; 21% advanced fibrosis; 18% depression; 28% fatigue). CHB-fatigue was associated with younger age, female, obesity, anxiety, depression (all p < 0.01) and worse PRO scores: CLDQ (scale 1-7): 4.1 ± 0.9 vs. 5.8 ± 0.9; FACIT score (range 0-108): 67.6 ± 14.5 vs. 87.7 ± 13.7; work productivity impairment (range 0-1): 0.33 ± 0.29 vs. 0.11 ± 0.22 (all p < 0.0001). Multivariable analysis confirmed the association of fatigue with lower PRO scores, impairment up to -23% (p < 0.01). CHC-fatigue was associated with female sex, obesity, type 2 diabetes, anxiety, depression (all p < 0.05) and worse PRO scores: CLDQ-HCV: 3.8 ± 1.0 vs. 5.5 ± 1.0; FACIT: 61.8 ± 14.1 vs. 85.6 ± 14.5; work productivity impairment: 0.49 ± 0.32 vs. 0.17 ± 0.25 (all p < 0.0001). In multivariable models, fatigue remained associated with reduced PRO scores, impairment up to -33% (p < 0.01). Almost one in five patients with chronic viral hepatitis report significant fatigue, which is associated with substantial PRO and work productivity impairment. Routine assessment for and management of fatigue in CHC or CHB care is essential.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"33 6","pages":"e70188"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964148","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}
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