Lancet Gastroenterology & Hepatology最新文献

{"title":"The use of pharmacotherapies in non-cirrhotic metabolic dysfunction-associated steatohepatitis: a UK expert consensus.","authors":"Jeremy F Cobbold, Hamish Miller, Kate Hallsworth, Pinelopi Manousou, Thomas Marjot, Michael E D Allison, Quentin M Anstee, Matthew J Armstrong, Leah Avery, Vian Azzu, Paul N Brennan, Christopher D Byrne, Tessa M Cacciottolo, Lynsey Corless, Daniel Forton, Timothy Hardy, Vanessa Hebditch, Helen Jarvis, Wenhao Li, Dina Mansour, Stuart McPherson, Yensiew Miao, Joanne Morling, Ashis Mukhopadhya, Benjamin Mullish, Richard Parker, Imran Patanwala, Jay Patel, Michael Pavlides, Tina Reinson, Ian A Rowe, Francesca Saffioti, Faisal Shaikh, Ankur Srivastava, Nwe Ni Than, Emmanuel Tsochatzis, Edvard Volcek, Jeremy W Tomlinson, William Alazawi","doi":"10.1016/S2468-1253(26)00077-4","DOIUrl":"https://doi.org/10.1016/S2468-1253(26)00077-4","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatohepatitis (MASH), a potentially progressive form of metabolic dysfunction-associated steatotic liver disease (MASLD), increases risk of fibrosis progression, cirrhosis, and liver-related and cardiometabolic morbidity. The first licensed pharmacotherapies, resmetirom and semaglutide, mark a shift in management but practical guidance for real-world implementation is lacking. The British Association for the Study of the Liver and British Society of Gastroenterology MASLD special interest group developed consensus recommendations on patient selection, lifestyle management, and follow-up for MASLD-MASH-specific pharmacotherapy. 37 participants participated in a Delphi process where draft statements developed in working groups were anonymously rated, discussed, and refined. Consensus (≥80% agreement) was reached for 49 statements. The group agreed on the following general recommendation. Two-step non-invasive tests, including the Fibrosis-4 index and vibration-controlled transient elastography, are recommended to identify patients with presumed stage F2-F3 fibrosis (ie, at-risk MASH). Individuals with liver stiffness more than 10 kPa but without evidence of cirrhosis should be considered eligible for treatment. Lifestyle behaviour change intervention should accompany pharmacological treatment, delivered by suitably trained practitioners without delaying access to medication. Treatment discontinuation is advised with evidence of disease progression, cirrhosis development, or drug-induced liver injury. These recommendations offer pragmatic guidance to clinicians and consensus clinical opinion to regulatory bodies to support equitable and effective use of new MASLD-MASH therapies.</p>","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":38.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of one or two cycles of dual immunotherapy with nivolumab and ipilimumab in patients with mismatch repair-deficient rectal cancer (RESET-R): interim results from a multicentre, single-arm, phase 2 trial.","authors":"Line Schmidt Tarpgaard, Laurids Østergaard Poulsen, Ismail Gögenur, Tobias Freyberg Justesen, Søren Rafael Rafaelsen, Nadia Øgaard, Christina Demuth, Claus Lindbjerg Andersen, Lise Ventzel, Pernille Øhlenschläger Larsen, Anne Ramlov, Ken Ljungmann, Michael Bødker Lauritzen, Laura Vittrup Diness, Jakob Lykke, Vinicius Araújo Barbosa de Lima, Søren Kjær, Søren Salomon, Per Vadgaard Andersen, Per Pfeiffer","doi":"10.1016/S2468-1253(26)00047-6","DOIUrl":"https://doi.org/10.1016/S2468-1253(26)00047-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mismatch repair-deficient (dMMR) tumours are highly sensitive to immune checkpoint blockade in the metastatic setting. Previous trials showed near-universal pathological responses after short-course dual immune checkpoint inhibition in patients with early-stage dMMR colon cancer, and high clinical complete response rates after 6 months of single-agent PD-1 blockade in patients with dMMR rectal cancer. We aimed to evaluate the activity and safety of a short duration of preoperative nivolumab and ipilimumab in patients with early or locally advanced dMMR rectal cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In the RESET-R trial, a multicentre, single-arm, phase 2 trial conducted in two hospitals in Denmark, we enrolled patients aged 18 years or older with histologically confirmed stage I-III dMMR rectal adenocarcinoma, an Eastern Cooperative Oncology Group performance status of 0 or 1, and no previous systemic or local therapy for rectal cancer. Patients received one cycle of nivolumab (3 mg/kg intravenously on days 1 and 15) and ipilimumab (1 mg/kg intravenously on day 1). Patients with definite tumour regression but without clinical complete response at day 43 received a second cycle (nivolumab 3 mg/kg intravenously on days 50 and 65 and ipilimumab 1 mg/kg intravenously on day 50). The primary endpoint was the proportion of patients with a clinical complete response at day 93, defined as no visible or palpable tumour on rectal digital examination, endoscopy, and MRI. In patients with digital and endoscopic complete response, and with non-complete response on MRI, the absence of viable tumour cells in a representative biopsy was also classified as clinical complete response. Patients who had a clinical complete response were recommended to proceed with a watch-and-wait strategy without surgery. Analyses were done in the intention-to-treat population. The study was designed as a Simon two-stage trial, with an analysis for futility after enrolment of 19 participants. The study was to continue to enrol an additional 20 participants if six or more of the initial 19 participants had a clinical complete response, and the regimen would be deemed worthy of further investigation if 16 participants of the total 39 had a clinical complete response. An early interim analysis (and dissemination of the findings) was approved by the trial protocol committee when it became apparent that this measure of success had been met after enrolment of the first 16 participants. The trial is registered with EU Clinical Trials (2022-500646-14-00); the study is ongoing and continues to enrol patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between Feb 1, 2023, and Oct 28, 2025, 16 patients (nine [56%] male, seven [44%] female) were enrolled. Four (25%) patients had stage I tumours, two (13%) had stage II tumours, and ten (63%) had stage III tumours. All patients received at least one cycle of nivolumab and ipilimumab. By day 93, all 16 patients (100·0% [95%","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":38.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifaximin in cirrhosis: when therapeutic drift meets antimicrobial stewardship.","authors":"Rajiv Jalan,Vishal C Patel,Saeed Shoaie","doi":"10.1016/s2468-1253(26)00076-2","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00076-2","url":null,"abstract":"This Viewpoint examines the evolving role of rifaximin in cirrhosis, arguing that therapeutic drift has outpaced evidence and antimicrobial stewardship. While rifaximin is effective for secondary prevention of recurrent overt hepatic encephalopathy, randomised trials have failed to demonstrate benefit for primary prevention of hepatic encephalopathy, prevention of acute-on-chronic liver failure, or broader disease modification. Concurrently, emerging microbiological and epidemiological data challenge the perception of rifaximin as a benign gut modulator. Prolonged exposure is associated with selection of antimicrobial resistance genes, rifaximin-resistant Enterobacter spp, and cross-resistance in Enterococcus faecium to last-line agents such as daptomycin. In a population already highly susceptible to multidrug-resistant infections and adverse transplant outcomes, this association with antimicrobial resistance raises important public health concerns. We argue for a recalibration of rifaximin use to evidence-based indications and for embedding antimicrobial stewardship principles within hepatology guidelines and policy.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"8 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Gastroenterol Hepatol 2022; 7: 202–03","authors":"","doi":"10.1016/s2468-1253(26)00094-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00094-4","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"279 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147681105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"André is an Idiot","authors":"Joe Moody","doi":"10.1016/s2468-1253(26)00093-2","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00093-2","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"52 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147681106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of metabolic dysfunction-associated steatotic liver disease, 1990–2023, and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2023","authors":"","doi":"10.1016/s2468-1253(26)00011-7","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00011-7","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is one of the most prevalent liver diseases globally, contributing to both economic and health-related challenges. We aimed to evaluate the global, regional, and national burden of MASLD from 1990 to 2023, quantify the contribution of identified modifiable risk factors, and project future prevalence up to the year 2050.&lt;h3&gt;Methods&lt;/h3&gt;Estimates of MASLD prevalence and disability-adjusted life-years (DALYs) were produced by age, sex, region, Socio-demographic Index (SDI), and Healthcare Access and Quality (HAQ) index across 204 countries and territories from 1990 to 2023 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. The MASLD burden attributable to three risk factors (smoking, high BMI, and high fasting plasma glucose) was assessed as part of the GBD comparative risk assessment. As a secondary analysis, we used these estimates to forecast MASLD prevalence up to 2050 using fasting plasma glucose and mean BMI as predictors. Furthermore, to examine the relative contributions of population ageing, population growth, and changes in MASLD prevalence rate to the forecasted changes in case counts from 2023 to 2050, we conducted a decomposition analysis.&lt;h3&gt;Findings&lt;/h3&gt;In 2023, approximately 1·3 billion (95% uncertainty interval [UI] 1·2 to 1·4) individuals were estimated to be living with MASLD (ie, 16·1% of the global population), with an age-standardised prevalence rate of 14 429·3 (95% UI 13 268·3 to 15 990·6) per 100 000 population, representing a percentage increase of 142·7% (95% UI 139·2 to 146·7) in crude numbers from 1990 (0·5 billion [0·5 to 0·6]) and of 28·6% (27·8 to 29·5) in the rate (11 217·2 [10 276·8 to 12 467·0] per 100 000 in 1990). An estimated 3·6 million (2·8 to 4·5) total DALYs were attributable to MASLD worldwide in 2023, corresponding to an age-standardised DALY rate of 39·6 (31·2 to 49·9) per 100 000 population. Despite a 116·3% (93·3 to 139·4) increase in crude DALYs (from 1·7 million [1·3 to 2·1] in 1990), its age-standardised estimate remained consistent (1·8% [–8·6 to 12·8]) from 1990 (38·9 [30·1 to 49·8] per 100 000) to 2023. There was substantial variation in age-standardised estimates across regions. North Africa and the Middle East had the highest prevalence rate (29 246·1 [26 848·3 to 32 048·7] per 100 000) and Andean Latin America showed the highest DALY rate (152·3 [114·1 to 194·7] per 100 000). By contrast, the high-income Asia Pacific region had the lowest prevalence rate (8653·5 [7923·7 to 9592·8] per 100 000) and east Asia had the lowest DALY rate (16·3 [13·5 to 19·9] per 100 000) among all GBD regions. North Africa and the Middle East showed disproportionately higher prevalence rates relative to other regions with similar SDIs. Lower SDIs and HAQs were associated with higher age-standardised DALY rates. The age-standardised prevalence r","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"55 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147666705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-onset colorectal cancer: rising rates require rising awareness","authors":"The Lancet Gastroenterology & Hepatology","doi":"10.1016/s2468-1253(26)00096-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00096-8","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"36 8-12 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147681104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared principles within HBV guidelines: aligning clinical approach with differentiated care for global elimination","authors":"Su Wang, Sabela Lens, You Hong, Norah Terrault, Jessica Hicks, Cary James, Chari Cohen, Saeed Hamid","doi":"10.1016/s2468-1253(26)00050-6","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00050-6","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"5 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority trial","authors":"Yang Yang, Zhichao Liu, Chunguang Li, Bin Li, Bentong Yu, Jun Yi, Xiaobin Zhang, Hezhong Chen, Hecheng Li, Lijie Tan, Rong Hua, Xufeng Guo, Xinyu Yang, Wenyan Ma, Yifeng Sun, Zhigang Li, Yi He, Hong Zhang, Yuchen Su, Haiyong Gu, Jun Liu, Ming Zhang, Jinchen Shao, Yuchen Han, Jian Tang, Chunlin Ye, Lei Jiang, Hao Peng, Maierhaba Maitiyasen, Yuanpeng He, Bowen Shi, Jiang Hong, Chaojing Lu, Weizheng Zhou, Shengguang Zhao, Liqin Zhao, Xiaoyan Chen, Zenghui Cheng, Yong Fang, Heng Jiao, Han Tang","doi":"10.1016/s2468-1253(25)00402-9","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00402-9","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Robot-assisted minimally invasive oesophagectomy is used increasingly worldwide. However, no large-scale, multicentre, randomised controlled trial has compared long-term survival as the primary endpoint between robot-assisted oesophagectomy and conventional thoracoscopic oesophagectomy. We aimed to confirm the non-inferiority in overall survival of robot-assisted oesophagectomy over thoracoscopic oesophagectomy in patients with resectable oesophageal squamous cell carcinoma.&lt;h3&gt;Methods&lt;/h3&gt;This multicentre, open-label, randomised, controlled, phase 3, non-inferiority trial (RAMIE) was conducted at six hospitals in China. Patients aged 18–75 years, with biopsy-proven squamous cell carcinoma, Eastern Cooperative Oncology Group scores of 0–2, and with tumour and nodal classifications of cT1–4a, N0–2, M0, or M1 (supraclavicular lymph nodes metastasis) were eligible. Patients were randomly assigned (1:1) using a computer-generated randomisation list and stratified by neoadjuvant therapy to robot-assisted oesophagectomy or thoracoscopic oesophagectomy, both with at least two-field lymphadenectomy. The primary endpoint was overall survival, analysed in the intention-to-treat population. The non-inferiority margin was 9% for 5-year overall survival (the upper limit of 95% CI of the hazard ratio [HR] was 1·33). Harms were assessed in the per-protocol population, defined as all eligible participants undergoing resection. This trial was registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, number &lt;span&gt;&lt;span&gt;NCT03094351&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; and is completed.&lt;h3&gt;Findings&lt;/h3&gt;Between Aug 2, 2017, and Dec 23, 2019, 362 patients were randomly assigned (183 to robot-assisted oesophagectomy and 179 to thoracoscopic oesophagectomy. 309 (85%) of 362 patients were men and 53 (15%) were women. Two patients in each group did not undergo resection and were excluded from the per-protocol population. Median follow-up of the planned final analysis was 71·5 months (IQR 63·9–81·8). At 5 years, overall survival was 69·4% (95% CI 62·1–75·6) with robot-assisted oesophagectomy versus 56·2% (48·5–63·2) with thoracoscopic oesophagectomy (HR 0·71, 95% CI 0·51–0·97), confirming non-inferiority (one-sided p&lt;sub&gt;non-inferiority&lt;/sub&gt;=0·0001; exploratory analysis of p=0·032 for superiority). Intraoperative conversions to open surgery were similar between study groups (seven [4%] of 181 patients in the robot-assisted group &lt;em&gt;vs&lt;/em&gt; six [3%] of 177 in the thoracoscopic group). Postoperative grade 3 or higher complications were comparable (22 [12%] of 181 patients in the robot","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"89 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of chronic hepatitis B and C in 2022 and progress towards elimination: a global report.","authors":"Fuqiang Cui,Diana Faini,Devin Razavi-Shearer,Homie Razavi,Casimir Manzengo Mingiedi,Monica Alonso Gonzalez,Ahmed Sabry Alaama,Antons Mozalevskis,Polin Chan,Kiyohiko Izumi,Mohamed Amine Ghrabi,Meg Doherty,Lesi Olufunmilayo,Niklas Luhmann,Catherine de Martel,Mae Dirac,Timothy B Hallett,Shevanthi Nayagam,Peter Vickerman,Daniel Low-Beer","doi":"10.1016/s2468-1253(25)00375-9","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00375-9","url":null,"abstract":"BACKGROUNDWHO has worked closely with member states to set baseline targets, monitor progress and gaps, and develop a strategy to achieve the elimination of viral hepatitis as a public health threat by 2030. This analysis aimed to use the latest data to assess global progress, identify gaps, and provide strategic support to countries and regions to scale up prevention and treatment services to meet global, regional, and country-level targets.METHODSData on key indicators for 2022 were collated in 2023, including prevalence, incidence, mortality, and the cascade of care for chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) infections. WHO country offices, regional offices, related departments, and partners were involved to verify and ensure the quality and completeness of the data. Data from 2022 were compared with historical data to monitor progress, and reported data were compared with expected data and targets to identify gaps in incidence and mortality.FINDINGSAs of June 30, 2023, WHO had received verified data reports from 187 of 194 countries and territories, including data contributions from collaborative partners. We estimated that, in 2022, globally, 254 million (3·27%) of 7758 million people were living with chronic HBV infection and 50 million (0·65%) people were living with HCV infection. Overall, five countries (China [83·7 million; 27·5%], India [35·3 million; 11·6%], Indonesia [18·9 million; 6·2%], Nigeria [15·7 million; 5·2%], and Pakistan [12·6 million; 4·2%]) accounted for 55% of the combined global burden of HBV and HCV. There were more than 2·2 million (95% CI 1·8-2·7) new chronic HBV and HCV infections and more than 1·3 million (95% CI 1·1-1·6) deaths due to HBV and HCV in 2022, with the majority of deaths due to HBV (1·1 million [95% CI 0·98-1·24]); as a result, the point estimate for deaths due to hepatitis in 2022 exceeded that of deaths due to tuberculosis in 2023 (1·25 million [95% UI 1·13-1·37]). There were 1·2 million new chronic HBV infections worldwide in 2022; 62·7% (771 000) of these new infections occurred in the African Region. In 2022, 34·1 million (95% CI 30·2-38·5) individuals living with HBV were diagnosed; of these, 6·6 million (95% CI 5·9-7·5) received antiviral treatment. In 2022, 25·7 million (95% CI 19·5-28·8) individuals were diagnosed with HCV infection and 12·5 million (95% CI 9·5-14·0) were treated with direct-acting antiviral drugs in 2015-22.INTERPRETATIONViral hepatitis represents a substantial burden of infectious disease globally, comparable with that caused by tuberculosis. Progress towards global hepatitis elimination is currently insufficient to meet the 2030 targets defined in the UN Sustainable Development Goals; efforts need to be rapidly and urgently scaled up across all regions. In particular, given the rising mortality due to hepatitis B globally, expansion of hepatitis B vaccination is a priority, particularly in the African Region, where the majority of new chronic HB","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"52 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147524658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}