Reviews in Medical Virology最新文献

{"title":"Post-Infectious Fatigue and Depression Following Dengue: A Systematic Review and Meta-Analysis of Associated Factors.","authors":"Anna Condé, Olivier Maillard, Chaturaka Rodrigo, Antoine Bertolotti, Carolina X Sandler, Andrew R Lloyd, Patrick Gérardin","doi":"10.1002/rmv.70164","DOIUrl":"10.1002/rmv.70164","url":null,"abstract":"<p><p>Post-dengue fatigue syndrome is a debilitating long-term condition that affects daily activities, quality of life, and productivity. Its underlying mechanisms remain unclear, but clinical similarities with post-dengue depression complicate differentiation. Therefore, we conducted a systematic review and meta-analysis to identify and compare factors associated with post-dengue fatigue and post-dengue depression. We searched PubMed, Science Direct, Web of Science and Google Scholar databases until 6 June 2025, with an update performed on 31 December 2025. This systematic review was conducted according to PRISMA guidelines. Meta-analyses were conducted to assess associations of demographic, biological, clinical, medical or psychosocial factors with post-dengue fatigue and post-dengue depression using pooled odds ratios (OR). The study protocol was registered in PROSPERO (CRD420250655004). Nine studies (2006-2023) covering 1470 patients were included. The systematic review identified 13 factors eligible for meta-analysis: twelve factors for post-dengue fatigue and one for post-dengue depression. Among these factors, female sex (OR 1.69, 95% CI: 1.33-2.14), myalgia (OR 3.45, 95% CI: 2.10-5.69), and severe dengue (OR 4.02, 95% CI: 1.45-11.13), particularly dengue haemorrhagic fever (OR 1.53, 95% CI: 1.04-2.24), were associated with post-dengue fatigue. No factor was associated with post-dengue depression in the meta-analysis. However, narrative synthesis revealed thrombocytopaenia as a shared factor of both outcomes. This study highlights risk profiles for post-dengue fatigue syndrome and depression, with female sex, myalgia, and dengue severity specifically associated with fatigue, while thrombocytopaenia might indicate a shared pathway. These findings support targeted surveillance and management strategies for at-risk patients and highlight the need for further research into post-dengue depression mechanisms.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70164"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Polyomaviruses of Clinical Relevance: Modes of Transmission and Associated Pathologies.","authors":"Joana M Oliveira, Cristina Luxo, Ana M Matos","doi":"10.1002/rmv.70166","DOIUrl":"10.1002/rmv.70166","url":null,"abstract":"<p><p>Polyomaviruses are non-enveloped viruses with double-stranded circular DNA genome. Currently, 13 members of the Polyomaviridae family have been classified as human polyomavirus (HPyVs). Despite high seroprevalence values have been reported for the majority of the HPyVs worldwide, the main mode of transmission remains to be elucidated, and simple and common routes, such as faecal-oral and respiratory have been suggested. In general, HPyVs are responsible for asymptomatic primary infection, followed by asymptomatic lifelong persistent infection. In situations of severe immunosuppression, viral reactivation of some HPyVs may occur and result in the development of associated clinical manifestations. JCPyV is the causative agent of Progressive Multifocal Leukoencephalopathy, BKPyV is associated with nephropathy among kidney transplant recipients, MCPyV with Merkel Cell Carcinoma and TSPyV with Trichodysplasia spinulosa. The association of certain HPyVs with severe diseases, in addition to the high seroprevalence of the majority of HPyVs, emphasises the need to address various knowledge gaps that still exists in the natural history of these viruses, including the transmission routes and the pathogenic mechanisms. The present review summarises current information on HPyV transmission routes and associated diseases, including diagnosis and available treatment options, highlighting the need for further studies.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70166"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HTLV-1-Driven Clonal Evolution and Immune Escape in Adult T-Cell Leukaemia: From Viral Persistence to Therapeutic Failure.","authors":"Zuhair M Mohammedsaleh, Abdullah F Shater","doi":"10.1002/rmv.70162","DOIUrl":"10.1002/rmv.70162","url":null,"abstract":"<p><p>Adult T-cell leukaemia/lymphoma (ATL) is an aggressive CD4 +T-cell malignancy caused by the human T-cell leukaemia virus type 1 (HTLV-1). Approximately 3%-5% of infected individuals develop ATL after a prolonged latency of 30-50 years, during which a complex interplay between viral oncoproteins and host genomic alterations drives the transition from viral persistence to overt malignancy. This transformation is orchestrated by the viral transactivator Tax, which initiates cellular transformation, and the HTLV-1 basic leucine zipper factor (HBZ), which maintains the malignant phenotype and promotes survival through immune evasion. Genomic profiling has revealed that over 90% of ATL cases harbour activating mutations in the T-cell receptor (TCR)-NF-κB signalling pathway, enabling the malignant clone to bypass viral dependency. Furthermore, ATL cells survive host immunosurveillance through sophisticated escape mechanisms, including the loss of MHC class I presentation and programed death-ligand 1 (PD-L1) overexpression via 3'-untranslated region (UTR) disruption. Despite the use of antiviral therapies and targeted monoclonal antibodies, therapeutic failure is common due to genomic instability-specifically TP53 mutations compromising Zidovudine/Interferon efficacy and CCR4 antigenic variations leading to mogamulizumab resistance. This review delineates the multi-step journey of HTLV-1-driven clonal evolution and evaluates the molecular barriers to effective clinical management.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70162"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Natural History of Human Papillomavirus (HPV) Infection in Males: Global Evidence From a Systematic Review and Meta-Analysis.","authors":"Jiaxing Qi, Haibin Wu, Rui Yan, Wenkai Zhou, Fang Shen, Juping Chen, Xingxing Zhang, Rui Bian, Changtai Zhu, Shigui Yang","doi":"10.1002/rmv.70168","DOIUrl":"10.1002/rmv.70168","url":null,"abstract":"<p><p>This systematic review provides a comprehensive global synthesis of male-specific infection patterns and determinants, aiming to inform targeted prevention and control strategies in public health. A systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 statement. We systematically searched PubMed, Embase, Wanfang, and CNKI for studies on the natural history of HPV infection in males published between January 1, 2003, and March 10, 2025. Meta-analyses were conducted to estimate pooled rates of HPV clearance, persistence, recurrence, progression and transmission. A total of 89 studies involving 68,477 males were included. The overall pooled clearance rate of any HPV in males was 71.04 per 1000 person-months (95% CI: 56.55-87.17). Clearance rates varied by anatomical site, with the lowest rate observed in the oral region (38.79 per 1000 person-months, 95% CI: 10.43-85.13), followed by the anal (65.14 per 1000 person-months, 95% CI: 49.04-83.52) and genital sites (89.40 per 1000 person-months, 95% CI: 66.52-116.99). Clearance rates were lower among men who have sex with men and people living with HIV (PLWH) compared with heterosexual men and those living without HIV, respectively. The pooled progression rate within 12-24 months was 20.75% (95% CI: 6.44%-40.28%). Female-to-male HPV transmission rates were higher than male-to-female transmission rates. The overall recurrence rate of anogenital warts was 50.00% (95% CI: 39.00%-60.00%). Risk factors associated with persistent infection included age over 30 years, current smoking, having male sexual partners, and CD4+ cell counts below 200 cells/mm³. The natural history of HPV infection in males exhibits considerable heterogeneity across behavioural, immunological, anatomical, and virological factors. These findings highlight the importance of including males, particularly high-risk populations, in HPV vaccination, surveillance, and prevention strategies to better inform clinical practice and public health policy.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70168"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Management of Congenital Cytomegalovirus Infection in an Era of Universal Newborn CMV Screening.","authors":"Emily R Harrison, W Charles Huskins, Mark R Schleiss","doi":"10.1002/rmv.70132","DOIUrl":"10.1002/rmv.70132","url":null,"abstract":"<p><p>The most common infectious disease responsible for paediatric developmental disability is congenital infection with human cytomegalovirus (cCMV). Many serious sequelae are caused by cCMV, including microcephaly, intracranial calcifications, neuronal migration defects, seizure disorders, developmental delay, and sensorineural hearing loss (SNHL). Although long-term neurodevelopmental impairment is clearly more common in newborns with clinically apparent disease at birth, more knowledge is needed about management in the era of universal cCMV screening, since screening identifies infants that, in the past, would not have been discovered during routine newborn care-infants that we reference in this review as having clinically inapparent cCMV (CICMV) infections. For newborns identified with CICMV infections by universal cCMV screening, longitudinal audiologic assessment is needed, but other necessary laboratory and neuroimaging studies, as well as indications for antiviral therapy, are uncertain. This review summarises current concepts about the approach to cCMV infections identified by universal screening, with emphasis on the CICMV infant. We identify areas for future research that should inform and direct future evaluation and management of these infants.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70132"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Usual Suspects: Emerging Associations Between Epstein-Barr Virus Infection/Infectious Mononucleosis and Cancers.","authors":"Marisa D Muckian, Graham S Taylor, John Diaz-Decaro, Enejda Senko, Helen R Stagg","doi":"10.1002/rmv.70153","DOIUrl":"10.1002/rmv.70153","url":null,"abstract":"<p><p>Epstein-Barr virus (EBV) is a ubiquitous herpesvirus and a causal factor for Burkitt Lymphoma (BL), Hodgkin Lymphoma (HL), gastric carcinoma (GC) and nasopharyngeal carcinoma (NPC). Whether EBV contributes to a wider spectrum of cancers remains uncertain. We reviewed MEDLINE, Embase and Web of Science on 30^th July 2024 to identify observational studies that examined the association between EBV infection or EBV-infectious mononucleosis (IM) and cancers beyond BL, HL, GC and NPC. Evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. For cancers meeting minimum thresholds we assessed etiologic fractions (EFs), biological plausibility, epidemiological burden, latency after IM, and predictive biomarkers. Thirty-three eligible studies were identified, yielding 13 hypotheses (i.e., specific potential reported associations between EBV infection or IM and individual cancer types) that advanced through GRADE. Breast cancer and NHL had the greatest weight of biological plausibility, cervical and prostate the least. Despite an array of tests, testicular cancer studies provided limited evidence. EFs ranged between 12.3% (IM-breast) and 85.1% (EBV infection-NHL). Breast and prostate cancers had the highest global incidence. Only one study (for NHL) provided data on time from IM to cancer onset, and prostate-specific antigen was the only biomarker identified. In this review, we highlight eight cancers across six cancer groups (breast, cervical, leukaemia/other haematologic, NHL, prostate, testicular) with some evidence of EBV involvement. These results reinforce the potential long-term value of EBV vaccine development, while emphasising the need for high-quality prospective studies with robust methods of viral detection to establish causality.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70153"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 Variants and Immune Evasion: Mapping the Future of Vaccine Design.","authors":"Fatih Uzer, Fulya Erendor, Salih Sanlioglu","doi":"10.1002/rmv.70157","DOIUrl":"10.1002/rmv.70157","url":null,"abstract":"<p><p>The evolutionary trajectory of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has progressed through several distinct phases since its zoonotic emergence, transitioning from initial human adaptation to an era of rapid antigenic drift and complex immune evasion. As of early 2026, the global landscape is dominated by highly evolved sublineages of the Omicron (B.1.1.529) variant, including the JN.1-descendent subvariants NB.1.8.1 and XFG. This review provides a comprehensive overview of the molecular mechanisms driving viral fitness, with a primary focus on the structural transformations within the spike (S) protein's receptor-binding domain (RBD), N-terminal domain (NTD), and S2 subunit. We examine the biophysical impacts of pivotal mutations, such as E484 K, K417 N, and F486P, alongside the phenomenon of convergent evolution and epistatic compensation. Furthermore, we provide an integrated analysis of current knowledge regarding the evolving dynamics of humoral and cellular immunity, exploring the challenges posed by immune imprinting and the decline of neutralizing antibody titers against antigenically distant strains. A comparative discussion of SARS-CoV-2 and seasonal influenza highlights divergent evolutionary paces but converging regulatory frameworks for annual vaccine updates. Finally, the current status of next-generation vaccine platforms is evaluated, specifically mosaic nanoparticles and mucosal delivery systems, which aim to provide pan-sarbecovirus protection and interrupt transmission. These insights are integrated into a policy framework focused on annual strain selection and enhanced genomic surveillance for sustainable long-term pandemic management.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70157"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of High-Dose and Standard-Dose Influenza Vaccines for Hospitalisation and Mortality in Adults Aged 65 and Older: An Updated Systematic Review and Meta-Analysis.","authors":"Bilal Wazir Khan, Muhammad Huzaifa Khattak, Muhammad Maaz Amjad, Shahreena Athar Siddiqui, Tayyaba Ikram Qazi, Hamdullah Rehmat, Muhammad Faaz Khan, Haris Wazir Khan, Affan Masaud Mian, Mohsin Ullah, Umer Zaryab Khan, Muhammad Abdur Rafay, Sajjad Ghanim Al-Badri, Zaryab Bacha","doi":"10.1002/rmv.70158","DOIUrl":"10.1002/rmv.70158","url":null,"abstract":"<p><p>This updated systematic review and meta-analysis evaluated the relative vaccine effectiveness (rVE) of high-dose inactivated influenza vaccine (HD-IV) versus standard-dose (SD-IV) in adults ≥ 65 years for key clinical outcomes, including hospitalisations and mortality. Conducted in accordance with PRISMA guidelines, PubMed, Embase, and the Cochrane Library were searched for randomised controlled trials. Primary outcomes were pneumonia and influenza (P&I) hospitalisation, all-cause hospitalisation, and all-cause mortality, while secondary outcomes included hospitalisation for cardiorespiratory disease, influenza-related hospitalisation, laboratory-confirmed influenza hospitalisation, and serious adverse events (SAEs). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using fixed-effect models. Across 586,188 participants, HD-IV reduced P&I hospitalisation (rVE 12.0%), increasing to 22.0% in sensitivity analysis. For all-cause hospitalisation (∼600,000 participants), rVE was 4.0%, while no significant reduction was observed for all-cause mortality (rVE = 2.0%). Subgroup analyses suggested greater benefits in individuals without cardiovascular disease and those aged 65-79 years. HD-IV also showed strong protection against influenza-specific outcomes (rVE 39% for influenza hospitalisation; 32% for laboratory-confirmed influenza hospitalisation), with no significant difference in SAEs between groups. Overall, HD-IV provides superior protection compared with SD-IV against P&I and all-cause hospitalisation in older adults, with the greatest benefits among younger seniors and those without cardiovascular disease. These findings support prioritising HD-IV to reduce influenza burden in the elderly, although benefits appear limited in adults aged > 80 years.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70158"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Cytomegalovirus Infection in Haematopoietic Stem Cell Transplant Recipients and CAR-T Cell Recipients-PART 2: Antiviral Therapy and Virus-Specific T Cell Therapy for HCMV in Allo-HSCT.","authors":"Gaurav Sutrave, Michelle K Yong, Danya Kaplan, David J Gottlieb, Allison Abendroth, Barry Slobedman, Emily Blyth, Lauren Stern","doi":"10.1002/rmv.70135","DOIUrl":"10.1002/rmv.70135","url":null,"abstract":"<p><p>Human cytomegalovirus (HCMV) reactivation is a common and significant complication after allogeneic haematopoietic stem cell transplantation (allo-HSCT), causing potentially life-threatening disease. Antiviral therapy approaches for HCMV are often limited by toxicities and the risk of developing antiviral drug resistance. This review article (Part 2) provides an overview of current antiviral pharmacotherapies for HCMV and the application of virus-specific adoptive T cell therapies for the prevention or treatment of HCMV reactivation in allo-HSCT recipients. The number of available antiviral drugs for HCMV is expanding, and letermovir primary prophylaxis is increasingly being adopted due to its favourable safety profile. Treatment resistant/refractory infections, end-organ disease, and late HCMV reactivations after antiviral therapy withdrawal continue to pose challenges. Adoptive HCMV-specific T cell therapies are a promising strategy for promoting immune-mediated control of HCMV reactivation in allo-HSCT recipients. The administration of HCMV-specific T cell products, generated through ex vivo expansion of donor-derived or partially HLA matched, third party HCMV-specific T cells, have demonstrated efficacy in combatting clinically significant HCMV infection in clinical trials. Adoptive HCMV-specific T cell therapies represent a powerful alternative approach for managing drug resistant HCMV infections in allo-HSCT recipients and reducing the reliance on antiviral pharmacotherapies.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70135"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Non-Vaccination Rate and Associated Factors Among Healthcare Workers in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.","authors":"Alphonce Ignace Marealle, Goodluck G Nyondo, Martine Aron Manguzu, Castory G Munishi, George Msema Bwire","doi":"10.1002/rmv.70169","DOIUrl":"10.1002/rmv.70169","url":null,"abstract":"<p><p>Hepatitis B virus (HBV) remains a significant occupational hazard for healthcare workers (HCWs), especially in low- and middle-income countries (LMICs) where vaccination coverage is often suboptimal. This review examined the non-vaccination rate against HBV among HCWs in LMICs. We conducted a systematic search across multiple databases, including PubMed/MEDLINE, Embase, Web of Science, and Scopus, for studies published from the inception up to 04 Feb 2024. Non-vaccination (NV) was defined as the absence of any hepatitis B vaccination dose as reported by individual studies. Pooled NV rates were calculated using a random-effects model. This review was registered in PROSPERO (CRD42024510223). The search retrieved 2990 studies, of which 62 met the eligibility criteria for the final analysis, including data from over 23,000 HCWs. The pooled prevalence of unvaccinated (zero-dose) HBV individuals was 36.2% (95% CI: 27.7%-45.5%; I² = 98.9%). Subgroup analysis revealed marked disparities, with the highest prevalence in low-income countries (61.4%; 95% CI: 30.6%-85.1%; I² = 98.7%) compared to upper-middle-income countries (20.4%; 95% CI: 7.8%-43.9%; I² = 98.8%). Regionally, the burden was greatest in Africa (45.3%; 95% CI: 32.7%-58.4%; I² = 98.9%) and lowest in Latin America (8.8%; 95% CI: 0.0%-99.9%; I² = 92.7). This review found that more than one-third of healthcare workers remain unvaccinated against HBV, with marked disparities across income levels and geographic regions. The consistently high heterogeneity suggests these gaps are context-specific, highlighting the need for targeted strategies to improve vaccine uptake and equity.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70169"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}