Journal of Viral Hepatitis最新文献

Hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) poses significant health challenges globally, particularly in regions with considerable HBV prevalence such as Egypt. Despite immunisation programmes, HBV remains a leading cause of liver cancer in Egypt, often diagnosed at advanced stages, complicating management and worsening prognosis. This retrospective multicentre study included 365 Egyptian patients diagnosed with HBV-related HCC between February 2007 and July 2023 from six tertiary care centres across Egypt. Clinical, laboratory, tumour characteristics, treatment outcomes and overall survival were collected and analysed. Diagnosis was confirmed according to international guidelines using triphasic CT or dynamic MRI. Treatment responses were assessed using modified RECIST criteria, and survival was analysed using Kaplan–Meier curves. Patients had a median age of 59 years, predominantly male (76.4%), and most (98.4%) presented with cirrhosis at diagnosis. The majority were not receiving antiviral treatment (76.71%) at presentation. Intermediate and advanced BCLC stages (B-D) comprised over 75% of cases. Trans-arterial chemoembolization was the primary treatment modality (34.5%), followed by sorafenib (24.1%) and best supportive care (28.8%). Median overall survival was 13.1 months. Independent factors associated with mortality included high ALBI score, positive HBV DNA at diagnosis, and advanced Child–Pugh classification. In conclusion: this study underscores the advanced stage at which HBV-related HCC is typically diagnosed in Egypt and the resulting poor survival outcomes. Strengthening early detection through surveillance programmes, increasing antiviral therapy coverage and adherence to treatment protocols are critical strategies to enhance patient prognosis.

Chronic hepatitis C (CHC) continues to be a significant public health issue in the United States, but comprehensive analysis of its epidemiological characteristics is limited. This analysis used data from the National Notifiable Diseases Surveillance System to examine patterns and changes in newly reported CHC. During 2016–2023, 895,522 CHC cases were newly reported among adults aged ≥ 18 years in the United States. The rate of newly reported cases during 2020–2023 was significantly lower (47.8 cases per 100,000), compared with the rate during 2016–2019 (75.8 cases per 100,000). A distinct bimodal age distribution was observed with age peaks centered at approximately 33.9 and 59.5 years, which corresponds to millennials (born during 1981–1996) and baby boomers (born during 1945–1965), respectively. While the bimodal age distribution persisted, over time, fewer cases contributed to the older peak relative to the younger peak. Males had a significantly higher rate of newly reported CHC than females, as did individuals residing in rural areas compared to urban areas, particularly within the younger peak. Variations in the transition from the older peak to the younger peak were observed across states during 2016–2023. These findings provide valuable insights into the evolving CHC epidemiology and the implications for the efforts to eliminate the disease.

Dental health professionals (DHPs) are at risk for bloodborne viruses. We evaluated hepatitis B and hepatitis C seroprevalence and knowledge, attitudes and practices regarding viral hepatitis in Georgia. We randomly selected 214 dental facilities. DHPs underwent face-to-face interviews and provided blood samples. High knowledge and practice were defined as correctly responding to 70% or more of the questions. Samples were tested for antibodies against hepatitis C virus (anti-HCV) and, if reactive, for HCV RNA; total hepatitis B core antibodies (anti-HBc) and, if reactive, for hepatitis B surface antigen (HBsAg). Specimens reactive for HBsAg were tested for antibody to hepatitis D virus (anti-HDV). Among 519 participants, 6.6% and 7.9% correctly identified all HBV and HCV transmission modes, respectively. Approximately half had high knowledge scores for hepatitis B and hepatitis C. Nurses had lower odds than dentists to have high scores. While 56% agreed that the hepatitis B vaccine is essential for healthcare workers, only 23.9% reported being vaccinated. Overall, 89.4% had high practice scores; 41.6% experienced a blood splash on their face, 43.7% a needle-stick injury and 20.6% an injury with a contaminated instrument. Practice scores were lower among those who had not been screened or vaccinated for hepatitis B. Among 517 blood samples tested, 0.8% were anti-HCV reactive, but none had detectable HCV RNA; 12.2% were anti-HBc reactive and 0.6% were HBsAg reactive. None tested reactive for anti-HDV. Enhanced training and policy reforms are critical to improve hepatitis knowledge, vaccination uptake and infection control practices among DHPs in Georgia.

NéoVie primary objective was to describe the care pathway of patients with HCV infection treated in addiction centres in France, by evaluating the rate of treatments initiated among these patients and to identify obstacles to treatment initiation. Multicentric, prospective, non-interventional study conducted in France from May 2020 to July 2022. Inclusion criteria were age > 18 years, positive HCV RNA, follow up in a participating addiction centre. Direct-acting antiviral (DAA) treatment was initiated at the discretion of the investigators. Patients initiating glecaprevir/pibrentasvir (G/P) treatment were followed for up to 11 months after treatment initiation. Data were collected through specific questionnaires. 32 centres participated in the study and 18 were active. Among the 93 patients included, 89 (95.7%) were treated with a DAA (77 (82.8%) with G/P). After G/P treatment initiation, all but 2 (which were reinfections) achieved SVR 12 and maintained virological response 6 months later. No AEs with a frequency > 3% were reported. Significant improvements were observed between inclusion and 11 months after in terms of quality of life (mean improvement of 6.78 ± 21.53 pts (VAS)) and anxiety and depression (10/37; 27.0% of the patients). These results suggest that once efforts are made in the centre to apply the simplified pathway, it is possible to treat and cure patients with DAA. In order to achieve HCV elimination goal, efforts to promote treatment should continue focusing on training and motivating addiction centres.

Despite long-standing national vaccination recommendations targeting high-risk groups, hepatitis B vaccination (HepB) coverage among US adults remains low. To inform efforts following the 2022 recommendation for universal adult HepB vaccination, we analysed data from the National Health Interview Survey (2000–2018) to estimate national HepB vaccination coverage and identify factors associated with vaccine uptake. We used Poisson regression and a health behaviour framework to examine associations across four domains: Sociodemographic characteristics, healthcare access, health-seeking behaviours, and access to health information. Among 532,168 non-institutionalised US adults aged ≥ 18 years, the self-reported HepB vaccination rate was 27.9% (95% CI 27.6–29.7), increasing from 22% in 2000 to 35% in 2018. Health-related behaviours showed the strongest association with HepB vaccination, including prior hepatitis A vaccination (AOR 11.17, 95% CI 10.51–11.87), prior hepatitis B testing (AOR 4.70, 95% CI 4.47–4.93), and prior hepatitis C testing (AOR 1.28, 95% CI 1.21–1.35). Conversely, older age, lower educational level, and recent unemployment were associated with lower odds of HepB vaccination. Additionally, Black and Hispanic adults had lower odds of vaccination compared to white adults. These findings highlight persistent gaps in HepB vaccine coverage among particular segments of the US population and underscore the importance of vaccination efforts that focus on these communities to mitigate existing disparities and achieve the goal of universal HepB vaccination.

Occult hepatitis B infection (OBI) represents a unique diagnostic and clinical challenge due to undetectable HBsAg despite HBV DNA presence. Genetic mutations, particularly in the HBV S gene, play a crucial role in immune evasion and diagnostic failures associated with OBI. This cross-sectional study investigated the genetic mutations in the S gene of HBV among family members of chronically infected patients. This study enrolled 243 family members from 62 HBV-infected index cases. Serological assays were used to identify HBsAg and anti-HBc positivity. HBV DNA was amplified and sequenced in 12 cases, focusing on the S gene. The impact of mutations in the S gene was assessed through in silico analyses, including epitope prediction and secondary structure modelling. Of the household contacts, 9.05% were HBsAg-positive and 37.03% were suspected OBI due to anti-HBc positivity. Out of the suspected OBI, 20% of individuals had detectable HBV DNA. Mutations like R122K and V194A were found to be enriched among OBI sequences and were shown to alter immune epitopes without affecting protein structure. Genotype D was predominant in chronic cases, while genotype A was more frequent in OBI. The adw2 serotype was commonly observed in OBI cases. Thus, this study highlights the role of S gene mutations in OBI's diagnostic and immune escape mechanisms. The findings underline the importance of genotype-specific diagnostic approaches and further investigations into the pre-S regions to enhance understanding of HBV pathogenesis.