Journal of Viral Hepatitis最新文献

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.

The World Health Organisation targeted the Hepatitis B virus (HBV) for elimination as a public health threat by 2030. To achieve this goal, equitable access to HBV testing and treatment services is critical. Migrants usually experience multiple barriers to accessing HBV services. Understanding HBV prevalence among this population can support planning for HBV elimination. This systematic review aimed to estimate HBV prevalence among migrants in high-income countries with low/intermediate HBV prevalence. PubMed, Scopus, PsycINFO and Cochrane Library were searched for peer-reviewed studies published between 2015 and 2025 in English. The Joanna Briggs Institute (JBI) Critical Appraisal Tools were used for methodological quality assessment. A proportional meta-analysis was used to estimate HBV prevalence. We also estimated the prevalence of HBV surface antibody (anti-HBs) positive from the included studies. Forty-four studies were included in this review. The pooled HBV surface antigen (HBsAg) and anti-HBs prevalence were 4.4% (95% CI: 3.4%–5.5%) and 35.2% (95% CI: 26.9%–44.0%), respectively. HBsAg prevalence was higher in males (5.8%) than in females (2.4%). Migrants aged 18 years and over had higher HBsAg prevalence than those aged less than 18 years (3.5% vs. 2.1%). Among refugees and asylum seekers, HBsAg and anti-HBs prevalence were 4.2% and 31.2%, respectively. The HBV prevalence among migrants was comparable to the global level, but higher than that in the general population of countries included in this study. To improve equity in HBV elimination strategies, migrants, especially refugees and asylum seekers' access to HBV information, testing, and treatment should be facilitated.

Despite advances in hepatitis C virus (HCV) treatments, diagnostic gaps and linkage-to-care hinder elimination efforts. We evaluated an electronic medical record (EMR)-based automated alert system to improve HCV care at tertiary referral centers. We have screened 1,303,578 patients who were tested for anti-HCV, and analyzed 8291 patients positive for anti-HCV antibody (Ab) across four tertiary hospitals between July 2009 and December 2023. The EMR alert system, implemented in June 2021, identified patients with positive anti-HCV antibody results who had not undergone HCV ribonucleic acid (RNA) testing. We compared HCV RNA testing rates, linkage-to-care and time intervals between testing before and after system implementation. The HCV RNA test prescription rate increased from 60.5% in the pre-alert period to 66.9% in the post-alert period. In non-hepatology departments, the prescription rate increased from 47.1% to 60.5%. The interval between HCV Ab positivity to HCV RNA test prescription in patients without initial HCV RNA order decreased significantly from 1208.9 to 244.5 days. Among 732 previously HCV RNA untested patients who were followed up after alert implementation, 43.4% received HCV RNA testing, leading to 62 new HCV diagnoses. The referral rate to hepatology departments remained stable (83.3% pre-alert vs. 80.9% post-alert). In conclusion, implementation of an EMR-based alert system effectively improved HCV diagnostic rates and reduced testing delays, particularly in non-hepatology departments. This system represents a promising strategy for hospital-based HCV micro-elimination, but additional interventions might be needed to achieve optimal testing rates and linkage-to-care.