Journal of Viral Hepatitis最新文献

Mongolia is a global hotspot for viral hepatitis, with estimated rates of chronic hepatitis B (HBV) of 11% and hepatitis C (HCV) of 8.5% among adults. Data on infections among children and young adults and the impact of vaccination against HBV are less clear. In 2018 and 2019, 3800 children and young adults aged 25 and younger from all provinces in Mongolia apart from Ulaanbaatar and Tuv were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), hepatitis B surface antibody (HBsAb), hepatitis C antibody (HCVAb) and hepatitis D antibody (HDVAb). HBsAg positive and serologically positive samples were evaluated for viremia. Risk factors for viral infection were assessed using a questionnaire. In total, 1.34% (51/3800) of participants were HBsAg positive. HBsAg positivity among 20–24 year-olds (5.4%) was 8.8 times higher than in those aged < 19 (0.6%). The prevalence of previous HBV infection was 6.7%. HBsAb without indication of prior infection, reflecting vaccination, was detected in 24.2%, declining with increasing age. Among HBsAg-positive samples, 86% (44/51) had detectable HBV-DNA and 27.45% tested positive for HDVAb (14/51). Only a family history of viral hepatitis was identified as a risk factor. A total of 0.31% (12/3800) of all participants were HCVAb positive. For HBV, the data generally show a much lower infection rate, especially among those born since 1998. Likely, the main reason for this decline is the infant vaccinations against HBV. For HCV, the low number of cases confirms that mostly older Mongolians are affected by HCV.

Viral hepatitis B infection is considered endemic in Greenland as in other Arctic areas. However, updated data are warranted after the implementation of screening, vaccination and treatment programmes during the past decades. We aimed to investigate the prevalence and disease characteristics of chronic viral hepatitis B (HBV), C (HCV) and delta (HDV) in Greenland. We performed a cross-sectional nationwide study using data from the electronic medical records extracted from 2014 to 2023. We identified 299 patients with HBV (positive of HBsAg) and 45 patients with HCV (positive of HCV-Ab and/or HCV-RNA), corresponding to an overall low prevalence of 0.53% (95%–CI: 0.49%–0.57%) and 0.08% (95%–CI: 0.06%–0.11%), respectively. The prevalence of HDV co-infection (positive of HDV-Ab and/or HDV-RNA) among patients with HBV was 9.4%, of whom 82% were HDV-RNA positive, indicating ongoing infection. Most of these patients were middle-aged and male. Additionally, the occurrence of HBV and HCV was higher among women compared to men in the age category 20–39 years. The most recent liver biochemistry, including Fibrosis-4 (FIB4) score, was within reference values among HBV-positive patients, while alanine and aspartate aminotransferase were slightly elevated among HCV-positive patients. A FIB4 score above 1.3 was observed in 28 (9%) with HBV, 2 (7%) of HBV-HDV positive patients, and 16 (36%) with HCV. The prevalence of HBV infection through routine testing in the healthcare system was markedly lower than prevalences reported in previous population screening studies. Yet, HDV co-infection is common and warrants increased awareness. HCV is rare, but more of these patients have elevated liver enzymes and FIB4 scores.

The Strategic Plan for Tackling Hepatitis C launched by the Ministry of Health in 2015 led to an important nationwide decrease in chronic hepatitis C-related hospitalisation rates by 2018 (25.8% of decrease compared to 2014 rates). This work aims to actualize the results on hepatitis C hospitalisation burden in Spain until 2023. Chronic HCV-related hospitalisation discharges from 2014 to 2023 were obtained from the Registry of Specialised Health Activity. A descriptive analysis of the hospitalisations was performed. All chronic, advanced liver disease (AdLD), and non-AdLD (N-AdLD) hospitalisation rates (HRs) were calculated at national and regional level. Hospitalisation rate ratios using 2014 as reference year were calculated using a Poisson model. From 2014 to 2023 there were 374,222 chronic HCV-related hospitalisations: 267,920 (71.6%) with N-AdLD and 106,302 (28.4%) with AdLD. Overall in-hospital fatality rate was 6.8%. In 2023, compared to 2014, national HRs decreased 49.7% (95% CI: 49.0% to 50.4%) for all chronic, 43.3% (95% CI: 42.4% to 44.3%) for N-AdLD and 62.6% (95% CI: 61.5% to 63.6%) for AdLD. At regional level, 10/19 Spanish regions achieved a decrease in the HRs of > 40%–60% and 1/19 of > 60%–80% for N-AdLD. For AdLD, 14/19 of the regions achieved a decrease in the HRs of > 60% (one of them, Ceuta, > 80% of decrease) and 3/19 a decrease of > 40%–60%. Following the implementation of the Strategic Plan, the hospital burden due to chronic HCV has continuously decreased in Spain. By 2023, the hospitalisation rate for chronic cases has been reduced to half.

During 2016–2023, 37 U.S. states experienced hepatitis A outbreaks associated with person-to-person transmission. We sought to describe the epidemiology of the outbreaks and characterise outbreak response efforts over time. We analysed outbreak databases from 37 states, survey responses from 33 states, and hepatitis A case reports from the National Notifiable Diseases Surveillance System for all 50 states and Washington, DC, during August 1, 2016–December 31, 2023. Among 44,930 reported outbreak-associated cases, most occurred among males (62%), non-Hispanic White persons (65%), and those aged 30–49 years (54%); 62% were hospitalised and 1% died. Commonly reported risk factors for HAV infection were drug use (53%) and homelessness or unstable housing (14%). Sixty-seven percent of adults had a documented indication for hepatitis A vaccination. In late 2017, CDC stood up a national incident management system to coordinate communication between outbreak-affected states, facilitate vaccine delivery, and provide technical assistance. States with available data reported administering more than 5.3 million adult hepatitis A vaccines collectively; most states administered vaccines in correctional facilities, local health departments and homeless shelters. Outbreak-associated cases peaked in 2019 and then declined annually. As outbreak response capacity scaled up nationwide, states with later outbreak start dates tended to experience smaller outbreaks than those with earlier start dates. Unprecedented hepatitis A outbreaks were controlled by a robust vaccine response in 37 states. Continued vigilance and providing access to vaccination for recommended populations will be critical to preventing similar outbreaks in the future.