Ways to Eliminate Viral Hepatitis as a Global Health Threat

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Viral Immunology, Vaccines, and Antivirals".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 25010

Special Issue Editor

Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
Interests: infectious diseases; viral hepatitis; liver; COVID-19
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hepatitis B (HBV) and C (HCV) have been recognized by the World Health Organization (WHO) as one of the major public health problems worldwide. Hepatotropic viruses are currently estimated to be responsible for the deaths of more than one million people each year, making them comparable in mortality to human immunodeficiency virus (HIV) infections, tuberculosis, and malaria. According to recent epidemiological reports, there are 71 million people living with HCV worldwide. The introduction of highly effective and safe direct-acting antivirals (DAAs) has radically changed the landscape and outlook for HCV treatment. In addition, this revolution on an unprecedented scale in the history of medicine has stimulated epidemiological research and encouraged research teams to create simulations and predictions. In 2016, WHO initiated an ambitious plan to eliminate viral hepatitis as a public health threat by 2030. Unfortunately, the implementation of this ambitious plan has been disrupted by the COVID-19 pandemic, resulting in a reduction in the number of screening tests performed and the number of patients treated for viral hepatitis. This special edition of Viruses aims to provide updated information on efforts and the chances of eliminating viral hepatitis as a global health threat.

Prof. Dr. Robert Flisiak
Guest Editor

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Keywords

  • HBV
  • HCV
  • viral hepatitis
  • therapy
  • screening
  • elimination

Published Papers (13 papers)

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Editorial

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4 pages, 200 KiB  
Editorial
Ways to Eliminate Viral Hepatitis as a Global Health Threat
by Robert Flisiak, Dorota Zarębska-Michaluk and Marta Flisiak-Jackiewicz
Viruses 2022, 14(7), 1554; https://0-doi-org.brum.beds.ac.uk/10.3390/v14071554 - 16 Jul 2022
Cited by 2 | Viewed by 1071
Abstract
Hepatitis B (HBV) and C (HCV) have been recognized by the World Health Organization [...] Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)

Research

Jump to: Editorial, Review, Other

11 pages, 554 KiB  
Article
Hepatitis C Virus Epidemiology in Lithuania: Situation before Introduction of the National Screening Programme
by Egle Ciupkeviciene, Janina Petkeviciene, Jolanta Sumskiene, Gediminas Dragunas, Saulius Dabravalskis, Edita Kreivenaite, Tadas Telksnys, Gediminas Urbonas and Limas Kupcinskas
Viruses 2022, 14(6), 1192; https://0-doi-org.brum.beds.ac.uk/10.3390/v14061192 - 30 May 2022
Cited by 3 | Viewed by 1619
Abstract
In 2022, the Lithuanian health authorities decided to pay general practitioners a fee for performing serological tests for hepatitis C virus (HCV) antibodies in the population born from 1945 to 1994 once per life and annual HCV testing for PWID and HIV infected [...] Read more.
In 2022, the Lithuanian health authorities decided to pay general practitioners a fee for performing serological tests for hepatitis C virus (HCV) antibodies in the population born from 1945 to 1994 once per life and annual HCV testing for PWID and HIV infected patients. This study aimed to assess trends in HCV-related mortality in the country and the prevalence of HCV infection among patients with liver diseases and evaluate possibilities of screening for HCV infection at a primary health care center. Age-standardized mortality rates in 2010–2020 were calculated for deaths caused by chronic hepatitis C and some liver diseases. Data on HCV infection among patients with liver cirrhosis, cancer and transplant patients were collected from the tertiary care hospital Kauno Klinikos. The prevalence of anti-HCV and risk factors of HCV infection was assessed among patients registered with the health care center in Klaipeda, where a pilot study of screening was performed. No steady trend in mortality was observed. Analysis of medical documentation showed that 40.5% of patients with liver cirrhosis, 49.7% with cancers and 36.9% of transplant patients were HCV infected. Over the year, 4867 patients were screened in the primary health care center. Positive anti-HCV prevalence was 1.7% (2.1% in men and 1.3% in women). Blood transfusion and being a blood donor before 1993 also having tattoos were associated with higher odds of HCV infection. The study revealed the active participation of individuals in HCV screening. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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8 pages, 792 KiB  
Article
Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions
by Valerio Rosato, Loreta A. Kondili, Riccardo Nevola, Pasquale Perillo, Davide Mastrocinque, Alessio Aghemo and Ernesto Claar
Viruses 2022, 14(5), 1096; https://0-doi-org.brum.beds.ac.uk/10.3390/v14051096 - 19 May 2022
Cited by 9 | Viewed by 1771
Abstract
Background: Free-of-charge HCV screening in some key populations and in 1969–1989 birth cohorts has been funded in Italy as the first step to diagnosing individuals who are infected but asymptomatic. The aim of this study is to evaluate the feasibility of an opportunistic [...] Read more.
Background: Free-of-charge HCV screening in some key populations and in 1969–1989 birth cohorts has been funded in Italy as the first step to diagnosing individuals who are infected but asymptomatic. The aim of this study is to evaluate the feasibility of an opportunistic HCV screening and its linkage to care. Methods: A hospital-based HCV screening was conducted as a routine test for in-patients admitted to the Evangelical Hospital Betania of Naples from January 2020 to May 2021. All consecutive in-patients were screened for the HCV antibody (HCV-Ab) at the time of their admission to the hospital, and those born prior to year 2000 were included in the study. HCV-RNA testing was required for those not previously treated and without antiviral treatment contraindications. For in-patients with an active infection, treatment started soon after hospital admission. Results: Among 12,665 inpatients consecutively screened, 510 (4%) were HCV-Ab positive. The HCV-Ab positivity rate increased with age, reaching the highest prevalence (9.49%) in those born before 1947. Among patients positive for HCV, 118 (23.1%) had been previously treated, 172 (33.9%) had been discharged before being tested for HCV-RNA, and 26 (5.1%) had not been tested for short life expectancy. Of 194 (38% of HCV-Ab+) patients who were tested for HCV-RNA, 91 (46.2%) were HCV-RNA positive. Of patients with active infection, 33 (36%) were admitted to the liver unit with signs of liver damage either not previously diagnosed or diagnosed but unlinked to care for HCV infection. Of the patients positive for HCV-RNA, 87 (95.6%) started treatment; all achieved sustained virological response. Conclusion: HCV active infection has been frequently found in patients with comorbidities admitted in the hospital in Southern Italy. To achieve HCV elimination in Italy, broader screening strategies are required. In addition to screening of the 1969–1989 birth cohort of individuals unaware of their infection status, diagnosis and linkage to care of patients with known liver damage is strictly required. Hospital screening is feasible, but prompt reflex testing for identifying HCV-active infections is necessary to increase diagnosis and subsequent linkage to care. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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9 pages, 460 KiB  
Article
The Influence of Treatment with Ledipasvir/Sofosbuvir on Growth Parameters in Children and Adolescents with Chronic Hepatitis C
by Maria Pokorska-Śpiewak, Anna Dobrzeniecka and Magdalena Marczyńska
Viruses 2022, 14(3), 474; https://0-doi-org.brum.beds.ac.uk/10.3390/v14030474 - 25 Feb 2022
Cited by 4 | Viewed by 1344
Abstract
: Background: There are limited data available on the influence of direct-acting antivirals used to treat chronic hepatitis C (CHC) on growth in children. In this study, we aimed to analyze the growth parameters in children treated with ledipasvir/sofosbuvir (LDV/SOF). Methods: We included [...] Read more.
: Background: There are limited data available on the influence of direct-acting antivirals used to treat chronic hepatitis C (CHC) on growth in children. In this study, we aimed to analyze the growth parameters in children treated with ledipasvir/sofosbuvir (LDV/SOF). Methods: We included 38 patients (16 girls and 22 boys) aged 10–17 years treated with LDV/SOF for CHC (33 infected with genotype 1 and 5 with genotype 4; 36 were treated for 12 weeks, and 2 for 24 weeks according to the current guidelines). Patient weight and height were measured at baseline, after 4 weeks of treatment, at the end of the treatment (EOT), and 12 weeks and one year after the EOT. Body mass index (BMI), BMI z and height-for-age (HA) z scores were calculated according to the WHO Child Growth Standards and Growth reference data using the WHO anthropometric calculator AnthroPlus v. 1.0.4. In addition, correlations between BMI z scores and liver fibrosis (liver stiffness measurement, LSM), the aspartate transaminase (AST)-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4) and liver steatosis (controlled attenuation parameter, CAP) were analyzed. Results: At baseline, 5/38 (13%) patients were obese (BMI z score >2 SD), 4/38 (11%) were overweight, and 29 (76%) were normal. A significant increase was observed in mean weight, height and BMI both 12 weeks and one year after the treatment compared to the baseline, whereas no differences were observed for BMI z scores and HA z scores. Baseline BMI z scores correlated with alanine aminotransferase levels (r = 0.33, 95% CI 0.01–0.58, p = 0.04), LSM (r = 0.40, 95% CI 0.09–0.65, p = 0.01), the APRI (r = 0.33, 95% CI 0.02–0.59, p = 0.03), and the CAP (r = 0.40, 95% CI 0.08–0.64, p = 0.01). No similar correlations were reported at 12 weeks posttreatment. Conclusions: Treatment with LDV/SOF in children with CHC (genotypes 1 and 4) did not negatively influence the patients’ growth. However, higher baseline BMI z scores correlated with more advanced liver fibrosis and steatosis in children with CHC. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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12 pages, 3117 KiB  
Article
Hepatitis C Screening and Treatment Program in Hungarian Prisons in the Era of Direct Acting Antiviral Agents
by Klára Werling, Béla Hunyady, Mihály Makara, Krisztina Nemesi, Gábor Horváth, Ferenc Schneider, Judit Enyedi, Zsófia Müller, Miklós Lesch, Zoltán Péterfi, Tamás Tóth, Judit Gács, Zsuzsanna Fehér, Eszter Ujhelyi, Emese Molnár and Anna Nemes Nagy
Viruses 2022, 14(2), 308; https://0-doi-org.brum.beds.ac.uk/10.3390/v14020308 - 02 Feb 2022
Cited by 3 | Viewed by 1933
Abstract
A hepatitis C virus (HCV) screening and treatment program was conducted in Hungarian prisons on a voluntary basis. After HCV-RNA testing and genotyping for anti-HCV positives, treatments with direct-acting antiviral agents were commenced by hepatologists who visited the institutions monthly. Patients were supervised [...] Read more.
A hepatitis C virus (HCV) screening and treatment program was conducted in Hungarian prisons on a voluntary basis. After HCV-RNA testing and genotyping for anti-HCV positives, treatments with direct-acting antiviral agents were commenced by hepatologists who visited the institutions monthly. Patients were supervised by the prisons’ medical staff. Data were retrospectively collected from the Hungarian Hepatitis Treatment Registry, from the Health Registry of Prisons, and from participating hepatologists. Eighty-four percent of Hungarian prisons participated, meaning a total of 5779 individuals (28% of the inmate population) underwent screening. HCV-RNA positivity was confirmed in 317/5779 cases (5.49%); 261/317 (82.3%) started treatment. Ninety-nine percent of them admitted previous intravenous drug use. So far, 220 patients received full treatment and 41 patients are still on treatment. Based on the available end of treatment (EOT) + 24 weeks timepoint data, per protocol sustained virologic response rate was 96.8%. In conclusion, the Hungarian prison screening and treatment program, with the active participation of hepatologists and the prisons’ medical staff, is a well-functioning model. Through the Hungarian experience, we emphasize that the “test-and-treat” principle is feasible and effective at micro-eliminating HCV in prisons, where infection rate, as well as history of intravenous drug usage, are high. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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19 pages, 639 KiB  
Article
Are There Still Difficult-to-Treat Patients with Chronic Hepatitis C in the Era of Direct-Acting Antivirals?
by Paweł Pabjan, Michał Brzdęk, Magdalena Chrapek, Kacper Dziedzic, Krystyna Dobrowolska, Katarzyna Paluch, Anna Garbat, Piotr Błoniarczyk, Katarzyna Reczko, Piotr Stępień and Dorota Zarębska-Michaluk
Viruses 2022, 14(1), 96; https://0-doi-org.brum.beds.ac.uk/10.3390/v14010096 - 06 Jan 2022
Cited by 10 | Viewed by 2181
Abstract
Difficult-to-treat populations with chronic hepatitis C (CHC), in the era of interferon treatment, included patients with liver cirrhosis, kidney impairment, treatment-experienced individuals, and those coinfected with the human immunodeficiency virus. The current study aimed to determine whether, in the era of direct-acting antivirals [...] Read more.
Difficult-to-treat populations with chronic hepatitis C (CHC), in the era of interferon treatment, included patients with liver cirrhosis, kidney impairment, treatment-experienced individuals, and those coinfected with the human immunodeficiency virus. The current study aimed to determine whether, in the era of direct-acting antivirals (DAA), there are still patients that are difficult-to-treat. The study included all consecutive patients chronically infected with hepatitis C virus (HCV) who started interferon-free therapy between July 2015 and December 2020 in the Department of Infectious Diseases in Kielce. The analyzed real-world population consisted of 963 patients, and most of them were infected with genotype 1 (87.6%) with the predominance of subtype 1b and were treatment-naïve (78.8%). Liver cirrhosis was determined in 207 individuals (21.5%), of whom 82.6% were compensated. The overall sustained virologic response, after exclusion of non-virologic failures, was achieved in 98.4%. The univariable analysis demonstrated the significantly lower response rates in males, patients with liver cirrhosis, decompensation of hepatic function at baseline, documented esophageal varices, concomitant diabetes, body mass index ≥25, and previous ineffective antiviral treatment. Despite an overall very high effectiveness, some unfavorable factors, including male gender, genotype 3 infection, liver cirrhosis, and treatment experience, significantly reduce the chances for a virologic response were identified. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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6 pages, 220 KiB  
Article
The Practicability of the Xpert HCV Viral Load Fingerstick Point-of-Care Assay in Primary Care Settings
by David Petroff, Olaf Bätz, Katrin Jedrysiak, Jan Kramer, Thomas Berg and Johannes Wiegand
Viruses 2021, 13(11), 2327; https://0-doi-org.brum.beds.ac.uk/10.3390/v13112327 - 22 Nov 2021
Cited by 6 | Viewed by 1530
Abstract
Linkage to care presents one obstacle toward eliminating HCV, and the current two-step pathway (anti-HCV, followed by HCV-RNA testing) results in the loss of patients. HCV screening was tested in the primary care setting with the fingerstick Xpert HCV viral load point-of-care assay [...] Read more.
Linkage to care presents one obstacle toward eliminating HCV, and the current two-step pathway (anti-HCV, followed by HCV-RNA testing) results in the loss of patients. HCV screening was tested in the primary care setting with the fingerstick Xpert HCV viral load point-of-care assay to analyze the practicability of immediate diagnosis. Anti-HCV (Cobas) and HCV-RNA (Cobas Amplicor version 2.0, only performed if anti-HCV was positive) were analyzed centrally as the gold standard. The Xpert assay was performed by 10 primary care private practices. In total, 622 patients were recruited. Five individuals (0.8%) were anti-HCV positive, and one was HCV-RNA positive. The Xpert test was valid in 546/622 (87.8%) patients. It was negative in 544 and positive in 2 cases, both of whom were anti-HCV negative. The HCV-RNA PCR and the Xpert test were both negative in 4/5 anti-HCV-positive cases, and the individual with HCV-RNA 4.5 × 106 IU/mL was not detected by the Xpert test. Primary care physicians rated the Xpert test practicability as bad, satisfactory, or good in 6%, 13%, and 81%, respectively, though 14/29 (48%) bad test ratings were assigned by a single practice. Despite adequate acceptance, interpretability and diagnostic performance in primary care settings should be further evaluated before its use in HCV screening can be recommended. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
10 pages, 586 KiB  
Article
A Comprehensive Coordinator Supported Hepatitis C Virus Testing and Linkage to Treatment Program at Kaiser Permanente Mid-Atlantic States
by Mary Cabell Jonas, Kevin Rubenstein, Eric Watson, Sundeep Basra and Michael Horberg
Viruses 2021, 13(11), 2140; https://0-doi-org.brum.beds.ac.uk/10.3390/v13112140 - 23 Oct 2021
Cited by 2 | Viewed by 1560
Abstract
Since 2020, the US Preventive Services Taskforce has recommended expanding hepatitis C virus (HCV) screening to include ages 18−79, in addition to baby boomers (born 1945−1965) and those at-risk for hepatitis C virus. This retrospective cohort analysis compared patients (18 years and above) [...] Read more.
Since 2020, the US Preventive Services Taskforce has recommended expanding hepatitis C virus (HCV) screening to include ages 18−79, in addition to baby boomers (born 1945−1965) and those at-risk for hepatitis C virus. This retrospective cohort analysis compared patients (18 years and above) tested for HCV through usual care versus a coordinator-supported program (HCV pathway) during 2015−2018 within Kaiser Permanente Mid-Atlantic States (KPMAS). In total, 131,176 patients were tested through the HCV pathway and 128,311 through usual care (non-standardized testing). Of those tested, 1.6% (HCV pathway) and 0.5% (usual care) had chronic HCV. Of those with chronic HCV, more patients tested within the HCV pathway completed hepatic transient elastography (82.6% HCV pathway vs. 45.6% usual care; p < 0.001) and a gastroenterology visit (72.2% HCV pathway vs. 46.5% usual care; p < 0.001), and had filled prescriptions for treatment (56.5% HCV pathway vs. 40.3% usual care; p < 0.001). The median time to complete each step was shorter for those tested through the HCV pathway (hepatic transient elastography (26 vs. 118 days), gastroenterology visit (63 vs. 131 days), and prescription fill (222 vs. 326 days)). More patients tested through a coordinator-supported, standardized testing pathway completed the necessary testing steps, in less time, compared to usual care. These findings may inform institutions seeking to create effective population-wide testing programs for HCV and other conditions. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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10 pages, 724 KiB  
Article
One-Year Outcomes after Ledipasvir/Sofosbuvir Treatment of Chronic Hepatitis C in Teenagers with and without Significant Liver Fibrosis—A Case Series Report
by Maria Pokorska-Śpiewak, Anna Dobrzeniecka and Magdalena Marczyńska
Viruses 2021, 13(8), 1518; https://0-doi-org.brum.beds.ac.uk/10.3390/v13081518 - 31 Jul 2021
Cited by 4 | Viewed by 1788
Abstract
One-year outcomes after therapy with ledipasvir/sofosbuvir (LDV/SOF) in children with chronic hepatitis C (CHC) presenting with and without significant liver fibrosis were analyzed. We included patients aged 12–17 years treated with LDV/SOF, presenting with significant fibrosis (F ≥ 2 on the METAVIR scale) [...] Read more.
One-year outcomes after therapy with ledipasvir/sofosbuvir (LDV/SOF) in children with chronic hepatitis C (CHC) presenting with and without significant liver fibrosis were analyzed. We included patients aged 12–17 years treated with LDV/SOF, presenting with significant fibrosis (F ≥ 2 on the METAVIR scale) in transient elastography (TE) at the baseline and we compared the outcomes with that of patients without fibrosis. Patients were followed every 4 weeks during the treatment, at the end of the therapy, at week 12 posttreatment, and one year after the end of treatment. Liver fibrosis was established using noninvasive methods: TE, aspartate transaminase-to-platelet ratio index (APRI), and Fibrosis-4 index (FIB-4). There were four patients with significant fibrosis at baseline: one with a fibrosis score of F2 on the METAVIR scale, and three with cirrhosis (F4) at baseline. One year after the end of treatment, the hepatitis C viral load was undetectable in three of them. One patient was lost to follow-up after week 4. In two out of the four patients, a significant improvement and regression of liver fibrosis was observed (from stage F4 and F2 to F0-F1 on the METAVIR scale). In one patient, the liver stiffness measurement median increased 12 weeks after the end of the treatment and then decreased, but still correlated with stage F4. An improvement in the APRI was observed in all patients. In four patients without fibrosis, the treatment was effective and no progression of fibrosis was observed. A one-year observation of teenagers with CHC and significant fibrosis treated with LDV/SOF revealed that regression of liver fibrosis is possible, but not certain. Further observations in larger groups of patients are necessary to find predictors of liver fibrosis regression. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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Review

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8 pages, 345 KiB  
Review
Elimination of HCV in Russia: Barriers and Perspective
by Vasily Isakov and Dmitry Nikityuk
Viruses 2022, 14(4), 790; https://0-doi-org.brum.beds.ac.uk/10.3390/v14040790 - 11 Apr 2022
Cited by 5 | Viewed by 1530
Abstract
Hepatitis C virus (HCV) is highly prevalent in Russia, representing the largest pool of hepatitis C patients in Europe. Effective treatment regimens with direct-acting antivirals can achieve HCV cure in all patients; therefore, in 2016 the World Health Organization proposed eliminating hepatitis C [...] Read more.
Hepatitis C virus (HCV) is highly prevalent in Russia, representing the largest pool of hepatitis C patients in Europe. Effective treatment regimens with direct-acting antivirals can achieve HCV cure in all patients; therefore, in 2016 the World Health Organization proposed eliminating hepatitis C as a public health threat by 2030. However, only a small number of countries are on track to meet the WHO’s hepatitis C elimination targets by 2030 due to many barriers in healthcare systems. This review focuses on a discussion about the epidemiology of HCV in Russia, the economic burden of HCV-related diseases, and treatment access with particular reference to the barriers for the elimination of HCV. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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12 pages, 287 KiB  
Review
Staging Fibrosis in Chronic Viral Hepatitis
by Ana Carolina Cardoso, Claudio Figueiredo-Mendes, Cristiane A. Villela-Nogueira and Patrick Marcellin
Viruses 2022, 14(4), 660; https://0-doi-org.brum.beds.ac.uk/10.3390/v14040660 - 23 Mar 2022
Cited by 7 | Viewed by 1989
Abstract
Staging fibrosis accurately has always been a challenge in viral hepatitis and other liver diseases. Liver biopsy is an imperfect gold standard due to its intra and interobserver agreement limitations and additional characteristics such as its safety and cost. Hence, non-invasive tests have [...] Read more.
Staging fibrosis accurately has always been a challenge in viral hepatitis and other liver diseases. Liver biopsy is an imperfect gold standard due to its intra and interobserver agreement limitations and additional characteristics such as its safety and cost. Hence, non-invasive tests have been developed to stage liver fibrosis. In addition to serological biomarkers, physical tests with reasonable accuracy are available and adopted in the daily clinic regarding viral hepatitis fibrosis staging. In this review, we discuss the published data regarding the staging of liver fibrosis in chronic hepatitis B and C, emphasizing non-invasive markers of fibrosis, both serological and physical. Moreover, we also discuss a persistent central gap, the evaluation of liver fibrosis after HCV cure. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
15 pages, 1442 KiB  
Review
HCV Elimination in Central Europe with Particular Emphasis on Microelimination in Prisons
by Robert Flisiak, Dorota Zarębska-Michaluk, Egle Ciupkeviciene, Sylvia Drazilova, Sona Frankova, Ivica Grgurevic, Bela Hunyady, Peter Jarcuska, Limas Kupčinskas, Michael Makara, Gunita Saulite-Vanaga, Marieta Simonova, Jan Sperl, Ieva Tolmane and Adriana Vince
Viruses 2022, 14(3), 482; https://0-doi-org.brum.beds.ac.uk/10.3390/v14030482 - 26 Feb 2022
Cited by 9 | Viewed by 2065
Abstract
In 2016, the WHO announced a plan to eliminate viral hepatitis as a public health threat by 2030. In this narrative review, experts from Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland and Slovakia assessed the feasibility of achieving the WHO 2030 [...] Read more.
In 2016, the WHO announced a plan to eliminate viral hepatitis as a public health threat by 2030. In this narrative review, experts from Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland and Slovakia assessed the feasibility of achieving the WHO 2030 target for HCV infections in Central Europe. They focused mainly on HCV micro-elimination in prisons, where the highest incidence of HCV infections is usually observed, and the impact of the COVID-19 pandemic on the detection and treatment of HCV infections. According to the presented estimates, almost 400,000 people remain infected with HCV in the analyzed countries. Interferon-free therapies are available ad libitum, but the number of patients treated annually in the last two years has halved compared to 2017–2019, mainly due to the COVID-19 pandemic. None of the countries analyzed had implemented a national HCV screening program or a prison screening program. The main reason is a lack of will at governmental and prison levels. None of the countries analyzed see any chance of meeting the WHO targets for removing viral hepatitis from the public threat list by 2030, unless barriers such as a lack of political will and a lack of screening programs are removed quickly. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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Other

15 pages, 754 KiB  
Perspective
The Importance of Prisons in Achieving Hepatitis C Elimination: Insights from the Australian Experience
by Rebecca J. Winter, Jacinta A. Holmes, Timothy J. Papaluca and Alexander J. Thompson
Viruses 2022, 14(3), 497; https://0-doi-org.brum.beds.ac.uk/10.3390/v14030497 - 28 Feb 2022
Cited by 6 | Viewed by 3294
Abstract
Following the availability of highly effective direct-acting antivirals (DAAs) to treat hepatitis C infection, the uptake of treatment by people living with hepatitis C rose dramatically in high- and middle-income countries but has since declined. To achieve the World Health Organization’s (WHO) 2030 [...] Read more.
Following the availability of highly effective direct-acting antivirals (DAAs) to treat hepatitis C infection, the uptake of treatment by people living with hepatitis C rose dramatically in high- and middle-income countries but has since declined. To achieve the World Health Organization’s (WHO) 2030 target to eliminate hepatitis C as a public health threat among people who inject drugs, an increase in testing and treatment is required, together with improved coverage of harm reduction interventions. The population that remains to be treated in high- and middle-income countries with high hepatitis C prevalence are among the most socially disadvantaged, including people who inject drugs and are involved in the criminal justice system, a group with disproportionate hepatitis C prevalence, compared with people in the wider community. Imprisonment provides an unrivalled opportunity for screening and treating large numbers of people for hepatitis C, who may not access mainstream health services in the community. Despite some implementation challenges, evidence of the efficacy, acceptability, and cost-effectiveness of in-prison hepatitis treatment programs is increasing worldwide, and evaluations of these programs have demonstrated the capacity for treating people in high numbers. In this Perspective we argue that the scale-up of hepatitis C prevention, testing, and treatment programs in prisons, along with the investigation of new and adapted approaches, is critical to achieving WHO elimination goals in many regions; the Australian experience is highlighted as a case example. We conclude by discussing opportunities to improve access to prevention, testing, and treatment for people in prison and other justice-involved populations, including harnessing the changed practices brought about by the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
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