Lancet Gastroenterology & Hepatology最新文献

{"title":"Long-term efficacy and safety of upadacitinib in patients with moderately to severely active ulcerative colitis: an interim analysis of the phase 3 U-ACTIVATE long-term extension study","authors":"Remo Panaccione, Séverine Vermeire, Silvio Danese, Peter D R Higgins, Gary R Lichtenstein, Hiroshi Nakase, Sarah Glover, Jean-Frédéric Colombel, Jason Eccleston, Michelle Kujawski, Valencia Remple, Xuan Yao, Ziqian Geng, Hannah Palac, Dolly Sharma, Smitha Suravaram, Stefan Schreiber","doi":"10.1016/s2468-1253(25)00017-2","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00017-2","url":null,"abstract":"<h3>Background</h3>The U-ACTIVATE long-term extension study aims to evaluate the long-term efficacy and safety of upadacitinib in patients with moderately to severely active ulcerative colitis. Here, we report interim results after 3 years of total treatment.<h3>Methods</h3>U-ACTIVATE is an ongoing, 288-week, phase 3, long-term extension study done at 307 centres across 43 countries (active sites on Dec 31, 2021, are presented as part of this interim analysis) and began on Jan 31, 2017. In brief, patients aged 16–75 years with a confirmed diagnosis of moderately to severely active ulcerative colitis for 90 days or more, an adapted Mayo score of 5–9, and an endoscopic subscore of 2 or 3 were eligible for the upadacitinib induction studies; patients who had a clinical response in the induction studies were eligible to enter the U-ACHIEVE maintenance study. Individuals who completed the U-ACHIEVE maintenance study were subsequently eligible for inclusion in the efficacy population of this long-term extension study. Patients in clinical remission per adapted Mayo score at week 52 of the maintenance study could continue their double-masked treatment upon entering the long-term extension study. Patients not in clinical remission originally randomly assigned to upadacitinib 15 mg were eligible to escalate to upadacitinib 30 mg, those originally randomly assigned to upadacitinib 30 mg continued on upadacitinib 30 mg, and those originally assigned to placebo were eligible to escalate to upadacitinib 15 mg in a masked way. We present data from weeks 48 and 96 of the long-term extension period. Key efficacy outcomes were clinical remission (per adapted Mayo score), endoscopic remission, maintenance of clinical remission, and maintenance of endoscopic remission, and are presented for those patients who had a clinical response after 8 weeks of upadacitinib 45 mg induction, completed 52 weeks of maintenance (U-ACHIEVE maintenance), and subsequently entered the long-term extension. Safety outcomes were treatment-emergent adverse events and adverse events of special interest, which were prespecified and were recorded in two populations: one comprising patients who received at least one dose of study drug in the long-term extension study and the other comprising all patients in the maintenance or long-term extension studies. Our primary approach for efficacy analysis was as-observed (ie, all observed data were used without imputation for missing data until patients switched to a different dose during the long-term extension study). This study is registered with ClinicalTrials.gov (NCT03006068).<h3>Findings</h3>414 patients from the phase 3 upadacitinib U-ACHIEVE maintenance study were eligible to enter this long-term extension study for assessment of efficacy endpoints following treatment with upadacitinib. Of these individuals, 369 patients (231 [63%] male individuals and 138 [37%] female individuals) were treated with upadacitinib in the long-term extension stu","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"286 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920362","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 pitfalls and promises of scoping reviews in gastroenterology literature – Authors’ reply","authors":"Carrie Levinson, Shabari Shenoy, Manasi Agrawal","doi":"10.1016/s2468-1253(25)00132-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00132-3","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"31 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920368","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":"Endoscopic ultrasonography-guided gastroenterostomy versus uncovered duodenal metal stenting for unresectable malignant gastric outlet obstruction (DRA-GOO): a multicentre randomised controlled trial","authors":"Anthony Yuen Bun Teoh, Sundeep Lakhtakia, Ilaria Tarantino, Manuel Perez-Miranda, Rastislav Kunda, Fauze Maluf-Filho, Vinay Dhir, Jahangeer Basha, Shannon Melissa Chan, Dario Ligresti, Mark Tsz Wah Ma, Carlos de la Serna-Higuera, Hon Chi Yip, Enders Kwok Wai Ng, Philip Wai Yan Chiu, Takao Itoi","doi":"10.1016/s2468-1253(25)00136-0","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00136-0","url":null,"abstract":"<h3>Background</h3>Endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) is a novel endoscopic method to palliate malignant gastric outlet obstruction. We aimed to assess whether the use of EUS-GE with a double balloon occluder for malignant gastric outlet obstruction could reduce the need for reintervention within 6 months compared with conventional duodenal stenting.<h3>Methods</h3>The was an international, multicentre, randomised, controlled trial conducted at seven sites in Hong Kong, Belgium, Brazil, India, Italy, and Spain. Consecutive patients (aged ≥18 years) with malignant gastric outlet obstruction due to unresectable primary gastroduodenal or pancreatobiliary malignancies, a gastric outlet obstruction score (GOOS) of 0 (indicating an inability to intake food or liquids orally), and an Eastern Cooperative Oncology Group performance status score of 3 or lower were included and randomly allocated (1:1) to receive either EUS-GE or duodenal stenting. The primary outcome was the 6-month reintervention rate, defined as the percentage of patients requiring additional endoscopic intervention due to stent dysfunction (ie, restenosis of the stent due to tumour ingrowth, tumour overgrowth, or food residue; stent migration; or stent fracture) within 6 months, analysed in the intention-to-treat population. Prespecified secondary outcomes were technical success (successful placement of a stent), clinical success (1-point improvement in gastric outlet obstruction score [GOOS] within 3 days), adverse events within 30 days, death within 30 days, duration of stent patency, GOOS at 1 month, and quality-of-life scores. This study is registered with ClinicalTrials.gov (NCT03823690) and is completed.<h3>Findings</h3>Between Dec 1, 2020, and Feb 28, 2022, 185 patients were screened and 97 (46 men and 51 women) were recruited and randomly allocated (48 to the EUS-GE group and 49 to the duodenal stent group). Mean age was 69·5 years (SD 12·6) in the EUS-GE group and 64·8 years (13·0) in the duodenal stent group. All randomly allocated patients completed follow-up and were analysed. Reintervention within 6 months was required in two (4%) patients in the EUS-GE group and 14 (29%) in the duodenal stent group [p=0·0020; risk ratio 0·15 [95% CI 0·04–0·61]). No significant difference in duration of stent patency was noted between groups. 1-month GOOS was significantly better in the EUS-GE group (mean 2·41 [SD 0·7]) than the duodenal stent group (1·91 [0·9], p=0·012). There were no statistically significant differences between the EUS-GE and duodenal stent groups in death within 30 days (ten [21%] <em>vs</em> six [12%] patients, respectively, p=0·286), technical success, clinical success, or quality-of-life scores at 1 month. Adverse events occurred 11 (23%) patients in the EUS-GE group and 12 (24%) in the duodenal stent group within 30 days (p=1·00); three cases of pneumonia (two in the EUS-GE group and one in the duodenal stent group) were considered to be pr","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"123 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920891","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":"Retraction and republication—Endoscopic ultrasonography-guided gastroenterostomy versus uncovered duodenal metal stenting for unresectable malignant gastric outlet obstruction (DRA-GOO): a multicentre randomised controlled trial","authors":"","doi":"10.1016/s2468-1253(25)00135-9","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00135-9","url":null,"abstract":"In December, 2023, <em>The Lancet Gastroenterology &amp; Hepatology</em> published the results of the DRA-GOO trial,<span><span>¹</span></span> comparing endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) versus uncovered duodenal metal stenting for patients with unresectable malignant gastric outlet obstruction.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"35 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920366","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":"U-ACTIVATE long-term efficacy and safety outcomes for upadacitinib in ulcerative colitis","authors":"Nurulamin M Noor, Miles Parkes, Tim Raine","doi":"10.1016/s2468-1253(25)00046-9","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00046-9","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"7 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920318","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":"Research in Brief","authors":"Holly Baker","doi":"10.1016/s2468-1253(25)00137-2","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00137-2","url":null,"abstract":"&lt;h2&gt;Section snippets&lt;/h2&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;&lt;span&gt;&lt;span&gt;FIT screening non-inferior to colonoscopy&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;&lt;/h2&gt;Faecal immunochemical test (FIT) screening is more widely accepted than colonoscopy and offers non-inferior protection against colorectal cancer mortality, according to the 10-year results of the COLONPREV trial.Antoni Castells and colleagues randomly assigned participants to receive an invitation to one-time colonoscopy (n=28 708) or FIT every 2 years (n=28 696). In the intention-to-screen population, participation was higher in the group invited to undergo FIT every 2 years (39·9%) than in&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;&lt;span&gt;&lt;span&gt;Active surveillance for oesophageal cancer&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;&lt;/h2&gt;Active surveillance is as safe as immediate surgery for patients with oesophageal cancer who achieve a clinical complete response following neoadjuvant chemoradiotherapy, according to 2-year outcomes from the phase 3 SANO trial.In a multicentre, stepped-wedge, cluster-randomised trial, Berend J van der Wilk and colleagues randomly assigned hospitals to switch from a standard surgical approach to active surveillance. Eligible patients had locally advanced oesophageal cancer and a clinical&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;&lt;span&gt;&lt;span&gt;Haemostatic gel fails to prevent post-procedure bleeding&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;&lt;/h2&gt;The application of a haemostatic gel following endoscopic mucosal resection of large flat lesions in the duodenum and colorectum does not reduce the rate of delayed bleeding, according to the PURPLE trial.Jan Drews and colleagues randomly assigned patients undergoing hot-snare endoscopic mucosal resection to receive haemostatic gel application (n=120) or no prophylaxis (control group; n=114). Prophylactic clip closure, which is currently standard of care for preventing delayed bleeding, was not&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;&lt;span&gt;&lt;span&gt;Capsule endoscopy-guided strategy for Crohn's disease&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;&lt;/h2&gt;Using video capsule endoscopy (VCE) to guide proactive treat-to-target therapy reduces the risk of disease exacerbation in Crohn's disease, according to the CURE-CD trial.Shomron Ben-Horin and colleagues randomly assigned patients w","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"27 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920369","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":"Organ preservation after total neoadjuvant therapy for locally advanced rectal cancer (CAO/ARO/AIO-16): an open-label, multicentre, single-arm, phase 2 trial","authors":"Cihan Gani, Emmanouil Fokas, Bülent Polat, Oliver J Ott, Markus Diefenhardt, Alfred Königsrainer, Simon Böke, Andreas Kirschniak, Robert Bachmann, Dörte Wichmann, Michael Bitzer, Stephan Clasen, Ulrich Grosse, Rüdiger Hoffmann, Martin Götz, Ralf-Dieter Hofheinz, Elisabeth Germer, Christoph-Thomas Germer, Rainer Fietkau, Peter Martus, Claus Rödel","doi":"10.1016/s2468-1253(25)00049-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00049-4","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Total neoadjuvant therapy has been shown to increase pathological complete response and disease-free survival in patients with locally advanced rectal cancer after total mesorectal excision (TME). We hypothesised that total neoadjuvant therapy could maximise the number of patients attaining a clinical complete response who could then be instead referred to organ preservation with watch and wait.&lt;h3&gt;Methods&lt;/h3&gt;This open-label, multicentre, single-arm, phase 2 study (CAO/ARO/AIO-16) was conducted at four centres across Germany. Patients aged 18 years or older with histologically confirmed cT1–2N1–2 or cT3a–dN0/N1–2 rectal adenocarcinoma up to 12 cm from the anal verge and without distant metastases received chemoradiotherapy. Radiotherapy was administered in daily fractions of 1·8 Gy, 5 days per week, starting at day 1 and ending at day 38, for a total of 28 fractions and total dose of 50·4 Gy. Concomitant fluorouracil (250 mg/m&lt;sup&gt;2&lt;/sup&gt; per day as a continuous venous infusion from day 1 to day 14 and day 22 to day 35) and oxaliplatin (50 mg/m&lt;sup&gt;2&lt;/sup&gt; intravenously on days 1, 8, 22, and 29) were administered. Chemoradiotherapy was followed by three cycles of consolidation FOLFOX (fluorouracil [2400 mg/m&lt;sup&gt;2&lt;/sup&gt; over 46 h by continuous venous infusion], oxaliplatin [100 mg/m&lt;sup&gt;2&lt;/sup&gt; intravenously as a 2-h infusion], and leucovorin [400 mg/m&lt;sup&gt;2&lt;/sup&gt; intravenously as a 2-h infusion]) starting on days 57, 71, and 85. Response assessment was scheduled on day 106 after the start of total neoadjuvant therapy and included digital rectal examination, rectoscopy, and pelvic MRI. In case of a clinical complete response, patients were scheduled for a watch and wait surveillance protocol. Patients with a near clinical complete response on day 106 were offered a second assessment on day 196. In case of conversion to a clinical complete response on this repeated assessment, the same watch and wait surveillance protocol was initiated. Alternatively, local excision was considered on day 196 if technically feasible. In all other cases, immediate TME surgery was recommended. The primary endpoint was the clinical complete response rate on day 106 or 196 assessed in patients who started chemoradiotherapy (intention-to-treat population). Toxicity was also assessed in this patient population. The study was registered with ClinicalTrials.gov (NCT03561142) and is complete.&lt;h3&gt;Findings&lt;/h3&gt;Between June 1, 2018, and Oct 7, 2020, we enrolled 93 patients, of whom 91 (mean age 61 years [SD 10]; 61 [67%] men and 30 [33%] women) started chemoradiotherapy, 88 started consolidation chemotherapy, and 88 had a response assessment on day 106. At this first assessment, 13 (15%) patients were classified as having a clinical complete response and were assigned to watch and wait, 33 (38%) met criteria for a near clinical complete response and were scheduled for reassessment, and 42 (48%) had a poor response and were referred for immediate TME. At the","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"228 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920581","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 pitfalls and promises of scoping reviews in gastroenterology literature","authors":"Morris Gordon","doi":"10.1016/s2468-1253(25)00098-6","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00098-6","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"35 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920367","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":"Inclusion of patients with isolated ulcerative proctitis in clinical trials","authors":"Andrew W Nguyen, Ashish R Srinivasan, Mark Lai, Tamar Schildkraut, Abhinav Vasudevan","doi":"10.1016/s2468-1253(25)00108-6","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00108-6","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"12 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920585","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":"Prevalence of hepatitis C virus seropositivity and active infection in a Rohingya refugee population in Cox's Bazar camps, Bangladesh: a cross-sectional study","authors":"Birgit Schramm, Khondaker A Ashakin, Wasim Firuz, Md Hadiuzzaman, Jihane Ben-Farhat, Andrés Arias-Rodríguez, Anisur Rahman, Pradip Sen Gupta, Abu Toha Rezuanul Haque Bhuiyan, Marve Duka, Suna Balkan, Farah Hossain","doi":"10.1016/s2468-1253(25)00094-9","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00094-9","url":null,"abstract":"<h3>Background</h3>Hepatitis C virus (HCV) infection is a significant public health concern. Limited data have shown unusually high HCV seroprevalence among Rohingya refugees residing in camps in Cox's Bazar, Bangladesh. We aimed to assess the prevalence of HCV seropositivity and active infection and identify risk factors to inform the HCV response.<h3>Methods</h3>A cross-sectional survey was conducted between May 10 and June 14, 2023, in adult (≥18 years) residents of seven camps in Cox's Bazar. Households were selected by simple random geosampling and one participant per household was selected at random. Participants were screened for HCV antibodies with a rapid finger prick blood test and, if seropositive, venous samples were tested for HCV viral load. A structured questionnaire collected information about demographics, HCV knowledge, and exposure risks. Survey-adjusted prevalence estimates of HCV seropositivity and active infection were generated by applying sampling weights. Factors associated with HCV seropositivity were identified using univariable and multivariable current status analysis and those associated with active infection via logistic regression.<h3>Findings</h3>The survey included 641 participants, of whom 425 (66%) were women and for whom the median age was 34 years (IQR 28–46). 191 individuals tested positive for HCV antibodies. 187 of these individuals were tested for active infection and 124 had a detectable HCV viral load. The survey-adjusted prevalence estimate of HCV seropositivity was 30·4% (95% CI 26·5–34·5), and that of active infection 19·8% (95% CI 16·5–23·4). Current status analysis identified higher odds of HCV seropositivity among individuals reporting medical injection(s) (adjusted odds ratio 1·8 [95% CI 1·2–2·8]) or surgery (5·9 [1·9–18·4]), and among women (2·1 [1·3–3·2]). 328 (51%) of 641 participants had never heard of hepatitis C. Five (4%) of 124 participants with HCV viraemia reported previous HCV treatment.<h3>Interpretation</h3>There is a substantial burden of active HCV infection among adult Rohingya camp residents, highlighting the urgent need to scale up testing and treatment capacities. The survey had constraints in identifying risk factors and could not provide data on HCV incidence. Reassessing infection prevalence after mass interventions and prospective surveillance are recommended to monitor ongoing transmission. A well-concerted multi-stakeholder action plan is needed to prevent future large-scale burden of severe liver disease and halt ongoing transmission.<h3>Funding</h3>Médecins Sans Frontières.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"43 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893414","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}