Journal of Viral Hepatitis最新文献

Hepatitis B virus (HBV) infection is a significant public health concern, particularly in low-income countries. This study investigates the prevalence and associated risk factors of HBV in Alamata district of Tigray region, northern Ethiopia, where the HBV vaccine was introduced in the childhood vaccination programme in 2007. A community-based, cross-sectional study was conducted from December 2019 to June 2020. Data were collected using structured questionnaires and hepatitis B surface antigen (HBsAg) was measured using a rapid diagnostic test. Logistic regression analyses were used to determine the associations between socio-demographic, behavioural and health-related variables and HBV infection. A total of 1853 individuals (54.2% females) were included in this study. The age ranged from 5 to 88 years, and the largest age group was from 5 to 14 years (32.0%). The overall HBV prevalence was 5.3% (95% confidence interval (CI) 4.3–6.3) with significant variability between age groups: 5–14 years 3.7%, 15–24 years 6.8%, 25–34 years 10.1%, 35–44 years 4.4%, 45–54 years 3.9% and 55 years and above 3.4%. Being in the 25–34 years age group (adjusted odds ratio (AOR) 4.1, 95% CI: 1.1–16.2, P= 0.042), reporting multiple sexual partners (AOR 4.0, 95% CI: 1.02–15.4, P= 0.047) and family history of hepatitis B (AOR 3.1, 95% CI: 1.2–8.2, P= 0.024) were independently associated with HBV infection. The prevalence of HBV infection was high in this region, underscoring the necessity for targeted public health strategies aimed at reducing transmission rates. Of note, the HBV prevalence was significantly lower among children born after the introduction of the HBV vaccine.

This study aimed to investigate the levels and longitudinal trajectories of medication adherence among patients with chronic hepatitis B (CHB), identify key psychosocial factors influencing adherence and provide evidence to inform strategies for optimising long-term treatment and enhancing patients' quality of life. A longitudinal study was conducted among CHB patients, 305 completing a 12-month follow-up. Medication adherence and psychosocial data were collected at baseline and at 3, 6, 9 and 12 months. K-means cluster analysis was performed to identify distinct adherence patterns, and differences in psychosocial characteristics across clusters were analysed. Four adherence trajectories were identified: improvement, low adherence, decline and high adherence. Significant differences were observed among the groups in terms of medication adherence scores and psychosocial factors (p < 0.05). Higher adherence was positively correlated with self-efficacy and social support, while lower adherence was associated with higher levels of perceived stigma and depression. Medication adherence among CHB patients exhibits distinct dynamic patterns, strongly influenced by psychosocial factors. Targeted interventions focusing on psychological support, stigma reduction and strengthening social support networks may improve adherence and ultimately enhance the quality of life for patients with chronic hepatitis B.

Delays in timely diagnosis and treatment of hepatitis delta virus (HDV) contribute to more severe liver disease at presentation. We aim to evaluate the prevalence and predictors of advanced liver disease at presentation among a national cohort of United States (U.S.) Veterans co-infected with chronic hepatitis B (CHB) and HDV. We retrospectively evaluated all U.S. Veterans with chronic HBV from 1/1/2010 to 12/31/2024 who underwent anti-HDV testing to evaluate the proportion who had advanced liver disease (cirrhosis, cirrhosis-related complications and hepatocellular carcinoma) at the time of HDV diagnosis. We performed sensitivity analyses among those who completed HDV RNA testing. Prevalence of advanced liver disease at the time of HDV testing was compared between anti-HDV positive and negative and among subgroups using chi-square testing. Among 29,061 chronic HBV patients, we identified 3558 patients who completed HDV testing during the study period, among whom 108 (3.0%) were anti-HDV positive and 3450 (97.0%) were anti-HDV negative. Anti-HDV positive patients had a significantly greater proportion of advanced liver disease compared to those who were anti-HDV negative (32.4% vs. 15.2%, p < 0.0001). Sensitivity analyses among patients who completed HDV RNA testing demonstrated similar trends of advanced liver disease (45.5% in HDV RNA positive vs. 18.6% in HDV RNA neg, p < 0.001). Among a national cohort of U.S. Veterans with chronic HBV, nearly 1 in 3 had already developed advanced liver disease at the time of HDV diagnosis, reflecting dangerous delays in diagnosis and treatment. Implementing effective programmes (e.g., reflex testing) to improve timely HDV diagnosis and treatment is urgently needed to prevent liver-related morbidity and mortality.

Data is limited regarding response to nucleos(t)ide analogs (NA) among patients with concurrent steatotic liver disease (SLD) and chronic hepatitis B (CHB). We investigated the outcomes of NA therapy between SLD-CHB and non-SLD CHB patients in a multinational CHB cohort. Adult CHB patients treated with ETV, TDF, or TAF from 28 sites (United States, Taiwan, Japan, Korea, China, Singapore, Argentina) were retrospectively analysed. SLD was diagnosed by imaging. Propensity score matching (PSM) was used to balance the SLD-CHB and non-SLD CHB groups, and competing risks analysis was used to compare incidence and sub-distribution hazard ratios (SHRs) of VR, BR, and CR. The study included 4600 patients (26.7% with SLD). SLD-CHB patients (vs. non-SLD CHB) were younger (49.4 vs. 50.9 years, p < 0.001), more likely male (68.0% vs. 61.6%), from the West (24.9% vs. 19.3%), and with higher BMI (25.3 vs. 23.5) but less likely to have advanced fibrosis (22.6% vs. 35.9%), all p < 0.001. Following PSM, baseline characteristics became balanced between the two groups. The 5-year cumulative rates for the SLD-CHB versus non-SLD CHB groups were as follows: VR (87.9% vs. 89.8%, p = 0.16), BR (86.8% vs. 89.2%, p = 0.096), and CR (77.5% vs. 81.0%, p = 0.085). After multivariable analysis, SLD-CHB patients had a significantly lower likelihood of achieving BR (SHR = 0.77, CI: 0.68–0.88, p < 0.001) and CR (SHR = 0.84, CI: 0.72–0.97, p = 0.019), but not VR. Among CHB patients treated with NA therapy, SLD was associated with a 23% lower likelihood of biochemical response and a 16% lower likelihood of complete response but did not impact virologic response.

Hepatitis B virus (HBV) infection is a serious public health concern worldwide, especially during pregnancy due to the associated health risks for the mother and fetus. This study aimed to explore the relationship between alanine aminotransferase (ALT) levels, age and HBV DNA levels in pregnant women with chronic HBV infection. Our cohort study included 1743 pregnant women with HBV who gave birth from January 2021 to June 2024. Participants were divided into three groups based on HBV DNA levels (log IU/mL): low (≤ 3.3; n = 691), moderate (3.3–4.3; n = 398) and high (> 4.3; n = 654). We used modified Poisson regression models and linear trend tests to assess the relationships between HBV DNA levels and gestational minimally raised alanine aminotransferase (MRALT, 40–80 U/L) or raised alanine aminotransferase (RALT, > 80 U/L). Additionally, we evaluated the associations between MRALT/RALT and obstetric outcomes. In pregnant women of advanced maternal age (≥ 35 years), HBV DNA was independently linked to a higher incident RALT risk but not to MRALT risk. A gradient was evident between HBV DNA levels and RALT risk (p for trend < 0.001). Significant links between RALT and premature birth, as well as low birth weight, were found in both participants younger than 35 years and those older than 35 years, but without statistical significance in the latter group. Age significantly modified the association between elevated HBV DNA levels and RALT risk, highlighting the importance of age-stratified monitoring in pregnant women with chronic HBV infection. This highlights the importance of targeted management to prevent adverse outcomes.