Journal of Viral Hepatitis最新文献

{"title":"Current research insights into the role of CTLA-4 in hepatitis B virus (HBV) infection","authors":"Qi Gu,&nbsp;Shengxia Yin,&nbsp;Xin Tong,&nbsp;Fajuan Rui,&nbsp;Yixuan Zhu,&nbsp;Xiaoyan Ma,&nbsp;Rui Huang,&nbsp;Chao Wu,&nbsp;Jie Li","doi":"10.1111/jvh.13958","DOIUrl":"10.1111/jvh.13958","url":null,"abstract":"<p>Chronic hepatitis B virus (HBV) infection is a significant global public health concern, and the clearance of HBV is closely linked to the activity of HBV-specific T cells, which is regulated by various co-suppressor molecules. Cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) is among these co-suppressor molecules which induces T cell exhaustion by competitively inhibiting CD28 and dampening the function of HBV-specific T cells. CTLA-4 also plays a role in the regulation of T helper (Th) cell differentiation and influences cytokine release. In addition, CTLA-4 can impact glucose metabolism in hepatocellular carcinoma through its interaction with T regulatory (Treg) cells. This review aims to provide a comprehensive overview of the existing literature related to the role of CTLA-4 in HBV patients across different subsets of T cells. Additionally, we propose a discussion on the possible mechanisms through which CTLA-4 may contribute to HBV infection, as well as the development of HBV-induced cirrhosis and hepatocellular carcinoma.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 9","pages":"557-564"},"PeriodicalIF":2.5,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070946","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":"Prevalence, clinical and virological characteristics and short-term prognosis of hepatitis delta infection among patients with HIV/HBV in Nouakchott, Mauritania","authors":"Hélène Le Guillou-Guillemette,&nbsp;Adeline Pivert,&nbsp;Ahmed ElBara,&nbsp;Mazouz Vall,&nbsp;Cindy Ng Wing Sang,&nbsp;Pascal Veillon,&nbsp;Alexandra Ducancelle,&nbsp;Mohamed Abdallahi Bollahi,&nbsp;Mohamed Sidi Mohamed,&nbsp;Françoise Lunel-Fabiani","doi":"10.1111/jvh.13950","DOIUrl":"10.1111/jvh.13950","url":null,"abstract":"<p>Patients living with HIV infection (PLWH) are at risk of acquiring HBV and HDV. The present study aimed to determine the prevalence and characteristics of HIV–HDV–HBV tri-infection in comparison with HIV–HBV coinfection and to estimate severities and outcomes of associated liver diseases in Mauritanian PLWH. Two-hundred-ninety-two consecutive HBsAg-positive PLWH were included (mean age: 37 years). Clinical data were recorded. Anti-HDV antibodies, HBV and HDV viral loads (VLs) and genotype were determined. APRI, FIB-4 and FibroScan were performed to evaluate the severity of liver disease. The anti-HDV antibodies prevalence was 37% and HDV RNA was positive in 40.7% of patients. Genetic diversities were found with HDV genotype 1 (93%) and HBV genotypes D (42.5%) and E (38%). The HBV VL was detectable in 108 patients at inclusion, and mutations associated with HBV resistance were found in 20. For almost all variables studied, including FIB-4 and APRI scores, no significant differences were found between anti-HDV-Ab positive or negative patients. FibroScan examination, which was performed in 110 patients at end-of-follow-up showed higher, but NS values, in HDV positive patients. After a mean follow-up of 24.55 ± 8.01 months (<i>n</i> = 217 patients), a highly significant worsening of APRI and FIB-4 scores was found. Moreover, patients with HDV showed more severe liver disease progression despite an efficient therapy. In a substantial Mauritanian cohort of relatively young PLWH, we found high HDV prevalence and worsening liver disease. In high-risk countries, screening for HDV and providing appropriate follow-up and treatments are warranted in PLWH.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 8","pages":"457-465"},"PeriodicalIF":2.5,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.13950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071052","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":"Epidemiology, linkage to care and natural history of women of childbearing age with chronic hepatitis B: A population-based study","authors":"Golasa Samadi Kochaksaraei,&nbsp;Fengjuan Yang,&nbsp;Cynthia H. Seow,&nbsp;Herman W. Barkema,&nbsp;Carla S. Coffin,&nbsp;Abdel-Aziz Shaheen","doi":"10.1111/jvh.13954","DOIUrl":"10.1111/jvh.13954","url":null,"abstract":"<p>Pregnant women with chronic hepatitis B (CHB) are a priority population for hepatitis B care. Identification of HBV status prior to pregnancy would facilitate timely maternal interventions and perinatal care. In our study, we aimed to study the epidemiology of CHB among women of childbearing age (WoCBA, 18–49 years) in Alberta, Canada. We retrospectively analysed Alberta Analytics databases to study CHB epidemiology, natural history and care linkage among WoCBA in Alberta, between April 2012 and March 2021. A Poisson regression was conducted to estimate incidence of newly identified CHB cases and prevalence trends, whereas predictors of care linkage were determined using logistic regression. Age/sex-adjusted incidence of newly identified CHB among WoCBA between 2015 and 2020 was 36.2/100,000 person/years, highest among individuals aged 30–39 years. Incidence of newly identified CHB decreased from 52.6 to 18.2/100,000 between 2015 and 2020, but prevalence increased from 131.7 to 248.6/100,000 in the same period. Newly identified CHB incident cases (<i>n</i> = 2124) had lower survival rates than age/sex-matched Canadians, with a standardized mortality ratio of 5.7 (95% CI 2.6–11.0). Increasing age (years) at diagnosis (HR, 1.2; 95% CI 1.1–1.3) was independently associated with mortality. Comorbid hepatocellular carcinoma, anti-HBV treatment and year of diagnosis were not significantly associated with mortality. Of the 1927 women with 2436 hepatitis B surface antigen-positive pregnancies from 2012 to 2020, only 27.6% had recommended HBV assessment during pregnancy. Of those women meeting criteria for antiviral therapy to prevent mother-to-child transmission (MTCT), only 66.4% received treatment. Suboptimal management during pregnancy and overall lower survival rates highlight the need to address care linkage barriers in women of childbearing age living with CHB.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 8","pages":"477-489"},"PeriodicalIF":2.5,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.13954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070947","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":"High prevalence of hepatitis C virus infection among incarcerated persons: Results from the Louisiana Hepatitis C Elimination Plan's opt-out testing program in prisons","authors":"Risha Irvin,&nbsp;Gia Landry,&nbsp;Miranda R. Jones,&nbsp;Anthony James,&nbsp;Jean Schexnayder,&nbsp;Stacye Rodriguez,&nbsp;Deborah Wendell,&nbsp;Kathryn Barthe,&nbsp;Elizabeth Britton,&nbsp;Kendra LeSar,&nbsp;Sean Manogue,&nbsp;Olivia K. Sugarman,&nbsp;Cynthia Brown,&nbsp;Samuel Burgess,&nbsp;Shruti H. Mehta,&nbsp;David L. Thomas,&nbsp;William Robinson,&nbsp;the Louisiana Hepatitis C Elimination Plan Team","doi":"10.1111/jvh.13941","DOIUrl":"10.1111/jvh.13941","url":null,"abstract":"<p>In the United States, modelling studies suggest a high prevalence of hepatitis C virus (HCV) infection in incarcerated populations. However, limited HCV testing has been conducted in prisons. Through the Louisiana Hepatitis C Elimination Plan, persons incarcerated in the eight state prisons were offered HCV testing from 20 September 2019 to 14 July 2022, and facility entry/exit HCV testing was introduced. Multivariable logistic regression was used to evaluate associations with HCV antibody (anti-HCV) positivity and viremia. Of 17,231 persons in the eight state prisons screened for anti-HCV, 95.1% were male, 66.7% were 30–57 years old, 3% were living with HIV, 68.2% were Black and 2904 (16.9%) were anti-HCV positive. HCV RNA was detected in 69.3% of anti-HCV positive individuals tested. In the multivariable model, anti-HCV positivity was associated with older age including those 30–57 (odds ratio [OR] 3.53, 95% confidence interval [CI] 2.96–4.20) and those ≥58 (OR 10.43, 95% CI 8.66–12.55) as compared to those ≤29 years of age, living with HIV (OR 1.68, 95% CI 1.36–2.07), hepatitis B (OR 1.83, 95% CI 1.25–2.69) and syphilis (OR 1.51, 95% CI 1.23–1.86). HCV viremia was associated with male sex (OR 1.89, 95% CI 1.36–2.63) and Black race (OR 1.42, 95% CI 1.20–1.68). HCV prevalence was high in the state prisons in Louisiana compared to community estimates. To the extent that Louisiana is representative, to eliminate HCV in the United States, it will be important for incarcerated persons to have access to HCV testing and treatment.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 7","pages":"432-435"},"PeriodicalIF":2.5,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956832","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":"Screening for hepatitis C virus at the time of mammography using rapid diagnostic tests in women aged between 50 and 74 years (Mamm'OC NCT05067374)","authors":"Magdalena Meszaros,&nbsp;Séverine Coursier,&nbsp;Nicolas Nagot,&nbsp;Lionel Moulis,&nbsp;Patrice Taourel,&nbsp;Emma Pages-Bouic,&nbsp;Nathalie Fabre-Demard,&nbsp;Muriel Trentini,&nbsp;Georges-Philippe Pageaux,&nbsp;Helene Donnadieu","doi":"10.1111/jvh.13947","DOIUrl":"10.1111/jvh.13947","url":null,"abstract":"<p>Chronic hepatitis C Virus (HCV) infection presents a global health challenge, with significant morbidity and mortality worldwide. Despite remarkable progress in treatment options, achieving elimination targets by 2030, as set by the World Health Organization, remains elusive. Our study aimed to address this gap by integrating HCV screening into a national breast cancer screening program. Between March 2022 and March 2023, a prospective cross-sectional multicenter study was conducted in four radiology centers in Montpellier, France. We proposed HCV screening to consecutive women undergoing mammography, targeting 1,500 participants aged 50–74 years. A rapid diagnostic test (RDT) for HCV antibodies (HCV Ab) was performed on capillary whole blood, with positive cases undergoing serological and RNA confirmation. Participants also completed a questionnaire on demographic data and risk factors. Acceptance rates, HCV prevalence, and linkage to care were assessed. The acceptance rate for this integrated screening approach was 82.4%. Notably, the seroprevalence of HCV was found to be 0.65%. Linkage to care was prompt, and the cascade of care demonstrated successful treatment outcomes. Importantly, the majority of detected infections were successfully resolved. These findings underscore the feasibility and acceptability of integrating HCV screening with breast cancer screening programs providing updated prevalence data and valuable insights for refining future screening strategies.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 7","pages":"416-422"},"PeriodicalIF":2.5,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.13947","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945045","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":"Incidence of primary hepatitis C infection among people who inject drugs during 2012–2020 in Athens, Greece","authors":"Sotirios Roussos,&nbsp;Christos Bagos,&nbsp;Theodoros Angelopoulos,&nbsp;Savvas Chaikalis,&nbsp;Evangelos Cholongitas,&nbsp;Spyridon Savvanis,&nbsp;Nikolaos Papadopoulos,&nbsp;Andreas Kapatais,&nbsp;Athina Chounta,&nbsp;Panagiota Ioannidou,&nbsp;Melani Deutsch,&nbsp;Spilios Manolakopoulos,&nbsp;Vasileios Sevastianos,&nbsp;Maria-Vasiliki Papageorgiou,&nbsp;Ioannis Vlachogiannakos,&nbsp;Maria Mela,&nbsp;Ioannis Elefsiniotis,&nbsp;Spyridon Vrakas,&nbsp;Dimitrios Karagiannakis,&nbsp;Fani Pliarchopoulou,&nbsp;Mina Psichogiou,&nbsp;Dimitrios Paraskevis,&nbsp;Peter Vickerman,&nbsp;Meni Malliori,&nbsp;Georgios Kalamitsis,&nbsp;Georgios Papatheodoridis,&nbsp;Angelos Hatzakis,&nbsp;Vana Sypsa","doi":"10.1111/jvh.13951","DOIUrl":"10.1111/jvh.13951","url":null,"abstract":"<p>One of the World Health Organization's targets for the 2030 viral hepatitis elimination strategy is to reduce new hepatitis C (HCV) infections. In Athens, Greece, people who inject drugs (PWID) have a high HCV prevalence, with increasing trends since the 2000s. This analysis aims to assess primary HCV incidence among PWID during 2012–2020. Two community-based interventions were implemented in 2012–2013 and 2018–2020 with repeated sero-behavioural surveys in each period. Participants enrolled in multiple surveys were identified through linkage. To assess trends in HCV transmission, three indicators were estimated: (i) anti-HCV prevalence among ‘new’ injectors (those injecting ≤2 years), (ii) indirect HCV incidence among ‘new’ injectors, assuming infection occurred at the midpoint between initiating injection and the first positive test, and (iii) HCV incidence from repeat participants. There were 431 and 125 ‘new’ injectors, respectively, in 2012–2013 and 2018–2020. Αnti-HCV prevalence [95% CI] declined from 53.6% [48.8%, 58.3%] in 2012–2013 to 40.0% [31.3, 49.1%] in 2018–2020 (25.4% reduction, <i>p</i> = .007). The indirect estimate [95% CI] of HCV incidence among ‘new’ injectors decreased from 56.1 [49.3, 63.8] to 39.0/100 person-years (PYs) [29.6, 51.5] (30.5% reduction, <i>p</i> = .020). HCV incidence [95% CI] based on seroconversions in repeat participants (16/63 in 2012–2013 and 9/55 in 2018–2020) declined from 64.6 [39.6105.4] to 13.8/100 PYs [7.2, 26.5], respectively (78.6% reduction, <i>p</i> &lt; .001). Primary HCV incidence remains high among PWID in Athens. Consistent implementation of combined interventions, including high-coverage harm reduction programs and initiatives tailored to increase access to HCV treatment, is essential to sustain the declining trends documented during 2012–2020.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 8","pages":"466-476"},"PeriodicalIF":2.5,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.13951","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922563","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":"Association of HBeAg decline rate from mid-pregnancy to delivery with HBeAg seroconversion after delivery in hepatitis B virus-infected mothers","authors":"Wenting Zhong,&nbsp;Jie Zheng,&nbsp;Naijuan Yao,&nbsp;Yali Feng,&nbsp;Yage Zhu,&nbsp;Zhe Jiao,&nbsp;Lanzhi Yan,&nbsp;Lei Shi,&nbsp;Yingli He,&nbsp;Tianyan Chen","doi":"10.1111/jvh.13948","DOIUrl":"10.1111/jvh.13948","url":null,"abstract":"<p>There is still controversy about whether to continue antiviral therapy (AVT) after delivery, especially for pregnant women in the immune tolerance (IT) phase. In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%) from mid-pregnancy to delivery and HBeAg seroconversion postpartum among patients using nucleos(t)ide analogs (NAs) to prevent mother-to-child transmission (MTCT), with the goal of identifying the ideal candidates for postpartum AVT continuation. This retrospective cohort study included 151 postpartum women. Univariate and multivariable logistic regression analyses were conducted to assess the association between the HBeAg decline rate (%) from mid-pregnancy to delivery and HBeAg seroconversion postpartum. Receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive capacity of the HBeAg decline rate (%) and determine the optimal cut-off point. The univariate analysis revealed a significant association between the HBeAg decline rate (%) and HBeAg seroconversion postpartum (OR 1.068, 95% CI: 1.034–1.103, <i>p</i> &lt; .001). In the multivariate regression analysis, adjusting for age, hepatitis B surface antigen (HBsAg) titre (log10 IU/mL) at mid-pregnancy, HBeAg titre (log10 S/CO) at mid-pregnancy, and hepatitis B virus (HBV) DNA load decline rate (%) from mid-pregnancy to delivery, the HBeAg decline rate(%) remained significantly associated with HBeAg seroconversion postpartum (OR 1.050, 95% CI: 1.015–1.093, <i>p</i> = .009). Then HBeAg decline rate (%) was treated as a categorical variable (tertiles) for sensitivity analysis. In the three distinct models, taking Tertile1 as a reference, women in Tertile3 still had a 4.201-fold (OR 4.201, 95% CI: 1.382–12.773, <i>p</i> = .011) higher risk of developing HBeAg seroconversion (<i>p</i> for trend &lt;.05) after adjusting above covariates. The area under the curve (AUC) was 0.723 (95% CI: 0.627–0.819). The optimal cut-off value was 5.43%, with a sensitivity of 0.561, specificity of 0.791, and Youden's index of 0.352.A higher HBeAg decline rate (%) from mid-pregnancy to delivery independently correlated with an increased risk of HBeAg seroconversion postpartum. This decline rate can serve as a valuable clinical indicator for predicting HBeAg seroconversion.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 8","pages":"439-445"},"PeriodicalIF":2.5,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898918","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 novel multi-epitope peptide vaccine candidate targeting hepatitis E virus: An in silico approach","authors":"Anoop Kumar,&nbsp;Utkarsha Sahu,&nbsp;Geetanjali Agnihotri,&nbsp;Anshuman Dixit,&nbsp;Prashant Khare","doi":"10.1111/jvh.13949","DOIUrl":"10.1111/jvh.13949","url":null,"abstract":"<p>Hepatitis E virus (HEV) is a foodborne virus transmitted through the faecal–oral route that causes viral hepatitis in humans worldwide. Ever since its discovery as a zoonotic agent, HEV was isolated from several species with an expanding range of hosts. HEV possesses several features of other RNA viruses but also has certain HEV-specific traits that make its viral–host interactions inimitable. HEV leads to severe morbidity and mortality in immunocompromised people and pregnant women across the world. The situation in underdeveloped countries is even more alarming. Even after creating a menace across the world, we still lack an effective vaccine against HEV. Till date, there is only one licensed vaccine for HEV available only in China. The development of an anti-HEV vaccine that can reduce HEV-induced morbidity and mortality is required. Live attenuated and killed vaccines against HEV are not accessible due to the lack of a tolerant cell culture system, slow viral replication kinetics and varying growth conditions. Thus, the main focus for anti-HEV vaccine development is now on the molecular approaches. In the current study, we have designed a multi-epitope vaccine against HEV through a reverse vaccinology approach. For the first time, we have used viral ORF3, capsid protein and polyprotein altogether for epitope prediction. These are crucial for viral replication and persistence and are major vaccine targets against HEV. The proposed in silico vaccine construct comprises of highly immunogenic and antigenic T-cell and B-cell epitopes of HEV proteins. The construct is capable of inducing an effective and long-lasting host immune response as evident from the simulation results. In addition, the construct is stable, non-allergic and antigenic for the host. Altogether, our findings suggest that the in silico vaccine construct may be useful as a vaccine candidate for preventing HEV infections.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 8","pages":"446-456"},"PeriodicalIF":2.5,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898916","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 economic argument for hepatitis B treatment simplification and expansion","authors":"Devin Razavi-Shearer","doi":"10.1111/jvh.13920","DOIUrl":"10.1111/jvh.13920","url":null,"abstract":"<p>One component of decisions regarding hepatitis B virus (HBV) treatment simplification and expansion is the economic perspective. Literature was reviewed for studies which provide estimates for the economic impact of simplifying and expanding treatment eligibility. Eight published studies and four unpublished studies were included and all but one subset of one study found that expanding treatment criteria would result in programs that would be at minimum cost-effective and most often highly cost-effective.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 S2","pages":"23-26"},"PeriodicalIF":2.5,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892035","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":"Hepatocellular carcinoma among patients with chronic hepatitis B in the indeterminate phase","authors":"Lung-Yi Mak,&nbsp;Leland J. Yee,&nbsp;Robert J. Wong,&nbsp;Christian B. Ramers,&nbsp;Catherine Frenette,&nbsp;Yao-Chun Hsu","doi":"10.1111/jvh.13914","DOIUrl":"10.1111/jvh.13914","url":null,"abstract":"<p>Hepatitis B virus (HBV) infection is a dynamic disease where patients progress through several stages defined by HBV e-antigen (HBeAg) status, HBV-DNA levels and transaminase elevations, with antiviral therapy indicated only in specific stages. However, some patients cannot be classified into one of the stages and are said to fall into an ‘indeterminate phase’ or ‘grey zone’. Exact definitions of the indeterminate phase vary from guideline to guideline as a result of different cut-off values for biomarker measurements. Data suggest that as many as 50% of HBV patients may be in an indeterminate phase and may not rapidly transition out of this phase. Clinical data that suggest these patients are at increased risk of hepatocellular carcinoma (HCC) are complemented by molecular evidence of integrations of HBV-DNA into the host genome, chromosomal translocations and immune activation despite liver enzymes that may suggest lack of inflammation. Antiviral therapy reduces these hepatocarcinogenic mechanisms and is reflected in a reduction of fibrosis and HCC risk. We review key data on patients in the indeterminate phase, with emphasis on HCC as an outcome. We take a holistic approach and link new biological data with clinical observations as well as examine the potential role of antiviral therapy in reducing HCC risk among patients in the indeterminate phase. With the availability of safe and effective oral antivirals, consideration must be given as to how much residual risk of HCC should be tolerated among patients in the indeterminate phase.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 S2","pages":"27-35"},"PeriodicalIF":2.5,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891990","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}