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Ways to Eliminate Viral Hepatitis as a Global Health Threat...
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Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0

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 (30 June 2023) | Viewed by 9906

Special Issue Editor

Prof. Dr. Robert Flisiak

E-Mail Website
Guest 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 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, 71 million people are 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, the 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 Issue 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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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

Published Papers (7 papers)

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Research

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10 pages, 431 KiB  
Article
Differences in HCV Seroprevalence, Clinical Features, and Treatment Outcomes between Female and Male Incarcerated Population: Results from a Matched Cohort Study
by Vito Fiore, Andrea De Vito, Elena Rastrelli, Valentina Manca, Giuseppe De Matteis, Roberto Ranieri, Emanuele Pontali, Nicholas Geremia, Sandro Panese, Giulio Starnini, Giordano Madeddu and Sergio Babudieri
Viruses 2023, 15(12), 2414; https://doi.org/10.3390/v15122414 - 12 Dec 2023
Cited by 1 | Viewed by 733
Abstract
Background: Women represent less than 5% of the incarcerated population in Italy, with very limited data on HCV infection. Higher HCV seroprevalence and active infection rates have been described among incarcerated females in available studies. Our aim is to compare the prevalence and [...] Read more.
Background: Women represent less than 5% of the incarcerated population in Italy, with very limited data on HCV infection. Higher HCV seroprevalence and active infection rates have been described among incarcerated females in available studies. Our aim is to compare the prevalence and cascade of care of HCV between male and female populations in Italian penitentiaries. Methods: We conducted a multicentre, retrospective study comparing HCV seroprevalence, active infections, treatment, and SVR rates between female (Group A) and male (Group B) populations in Italian prison settings. Results: No significant differences were found between the two groups regarding PWIDs (p = 0.16), nor in people living with HIV (p = 0.35) or HBV co-infection (p = 0.36). HCV seroprevalence was higher in Group A (p = 0.002). There was no statistically significant difference between the two groups regarding active infections (p = 0.41). Both groups showed a low level of fibrosis, and the dominant genotype was 3a. Almost all patients underwent antiviral treatment. All treated patients achieved SVR12. Conclusions: Our findings illuminate the importance of recognizing and addressing gender differences in HCV seroprevalence within penitentiary settings. Moving forward, addressing the unique needs of incarcerated females and optimizing HCV care for all incarcerated individuals are essential steps in the pursuit of achieving HCV micro-elimination goals. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0)
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10 pages, 2978 KiB  
Communication
Country-Wide HCV Elimination Strategies Need to Reach Older Patients in the General Population: The Italian Experience
by Pietro Torre, Roberta Coppola, Mario Masarone and Marcello Persico
Viruses 2023, 15(11), 2199; https://doi.org/10.3390/v15112199 - 31 Oct 2023
Viewed by 950
Abstract
HCV infection is still a major burden worldwide, and most countries are not on track to meet the WHO 2030 elimination goal. The current challenge is to identify individuals to be treated. In this study, we will describe the trend of new DAA [...] Read more.
HCV infection is still a major burden worldwide, and most countries are not on track to meet the WHO 2030 elimination goal. The current challenge is to identify individuals to be treated. In this study, we will describe the trend of new DAA prescriptions and the changes over time in terms of the characteristics of patients starting antiviral therapy in our unit. Data of 1646 hepatitis C patients who started therapy during the period of 2015–2022 regarding annual number of prescriptions, age, gender, nationality, HCV genotype, provenance, and liver disease severity were analyzed. We observed a peak in the number of new prescriptions in 2018 and a downward trend starting in 2019. Patients from the general population, centers for addictions, and prison differed significantly. The mean age in the general population remained above 60 years, the percentage of patients from centers for addictions and prison increased and, after 2016, there was no significant change in the percentage of patients with F3–F4 fibrosis. As HCV screening and linkage-to-care pathways seem to be already well implemented and successful in centers for addictions and in prisons, efforts need to be focused on those of older age in the general population. To carry this out, the more structured involvement of different health professionals must be figured out. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0)
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16 pages, 2762 KiB  
Article
Global Elimination of HCV—Why Is Poland Still So Far from the Goal?
by Olga Tronina, Mariusz Panczyk, Dorota Zarębska-Michaluk, Joanna Gotlib and Piotr Małkowski
Viruses 2023, 15(10), 2067; https://doi.org/10.3390/v15102067 - 09 Oct 2023
Viewed by 969
Abstract
Introduction: Eradication of HCV in the global population remains one of the greatest challenges faced by the WHO. An insufficient level of knowledge and the lack of a national screening test strategy are obstacles to HCV eradication. Aim: This work aimed to summarize [...] Read more.
Introduction: Eradication of HCV in the global population remains one of the greatest challenges faced by the WHO. An insufficient level of knowledge and the lack of a national screening test strategy are obstacles to HCV eradication. Aim: This work aimed to summarize surveys assessing risk factors and awareness of the respondents regarding the prevention and course of HCV infection. The summary also includes the most important European and global attempts at eliminating HCV. Materials and Methods: A cross-sectional, population-based study was conducted in the Mazowieckie district in Poland using anonymous surveys and conducted on people who willingly reported for a test. Results: In the study cohort of n = 7397 adults, there were 5412 women (73.16%). The analysis of the quota sample (n = 1303) reflected the actual proportions in the population of the Mazowieckie Voivodeship. Conclusions: Insufficient knowledge about HCV decreases the probability of higher detection of infections, fast diagnostics, and treatment. According to the WHO model, assuming a 90% detection rate and treatment of 80% of infected by 2030, and taking into account 120–150 thousand infected persons in Poland, the number of detections of HCV should be increased 4–5 times and all diagnosed persons should be offered antiviral treatment. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0)
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10 pages, 652 KiB  
Article
Collaborative Referral Model for Hepatitis C Screening and Treatment in a Remote Mountainous Region of Taiwan during the COVID-19 Pandemic
by Chi-Ming Tai, Ming-Jong Bair, Tzu-Haw Chen, Cheng-Hao Tseng, Chih-Cheng Chen, Hung Lam and Ming-Lung Yu
Viruses 2023, 15(4), 827; https://doi.org/10.3390/v15040827 - 24 Mar 2023
Viewed by 1280
Abstract
Community-based screening for the hepatitis C virus (HCV) decreased during the COVID-19 pandemic. We developed a collaborative referral model between a primary clinic (Liouguei District Public Health Center, LDPHC) and a tertiary referral center to increase HCV screening and treatment uptake in a [...] Read more.
Community-based screening for the hepatitis C virus (HCV) decreased during the COVID-19 pandemic. We developed a collaborative referral model between a primary clinic (Liouguei District Public Health Center, LDPHC) and a tertiary referral center to increase HCV screening and treatment uptake in a mountainous region of Taiwan. Once-in-a-lifetime hepatitis B and C screening services established by the Taiwan National Health Insurance were performed at LDPHC. Antibody-to-HCV (anti-HCV)-seropositive patients received scheduled referrals and took a shuttle bus to E-Da hospital for HCV RNA testing on their first visit. Direct-acting antiviral agents (DAAs) were prescribed for HCV-viremic patients on their second visit. From October 2020 to September 2022, of 3835 residents eligible for HCV screening in Liouguei District, 1879 (49%) received anti-HCV testing at LDPHC. The overall HCV screening coverage rate increased from 40% before referral to 69.4% after referral. Of the 79 anti-HCV-seropositive patients, 70 (88.6%) were successfully referred. Of the 38 HCV-viremic patients, 35 (92.1%) received DAA therapy, and 32 (91.4%) achieved sustained virological response. The collaborative referral model demonstrates a good model for HCV screening and access to care and treatment in a Taiwan mountainous region, even during the COVID-19 pandemic. Sustained referral is possible using this routine referral model. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0)
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15 pages, 753 KiB  
Article
Rescue Therapy after Failure of HCV Antiviral Treatment with Interferon-Free Regimens
by Olga Tronina, Michał Brzdęk, Dorota Zarębska-Michaluk, Dorota Dybowska, Beata Lorenc, Ewa Janczewska, Włodzimierz Mazur, Anna Parfieniuk-Kowerda, Anna Piekarska, Rafał Krygier, Jakub Klapaczyński, Hanna Berak, Jerzy Jaroszewicz, Aleksander Garlicki, Krzysztof Tomasiewicz, Jolanta Citko and Robert Flisiak
Viruses 2023, 15(3), 677; https://doi.org/10.3390/v15030677 - 04 Mar 2023
Cited by 3 | Viewed by 1794
Abstract
Direct-acting antivirals (DAA) regimens have provided hope for eliminating hepatitis C virus (HCV) infection. Patients following ineffective therapy with DAA, especially those previously treated with inhibitors of non-structural protein 5A (NS5A), remain a challenge. The study aimed to assess the effectiveness of DAA [...] Read more.
Direct-acting antivirals (DAA) regimens have provided hope for eliminating hepatitis C virus (HCV) infection. Patients following ineffective therapy with DAA, especially those previously treated with inhibitors of non-structural protein 5A (NS5A), remain a challenge. The study aimed to assess the effectiveness of DAA pangenotypic options in patients after failure of NS5A containing genotype-specific regimens. The analysis included 120 patients selected from the EpiTer-2 database with data on 15675 HCV-infected individuals treated with IFN-free therapies from 1 July 2015 to 30 June 2022 at 22 Polish hepatology centres. The majority of them were infected with genotype (GT) 1b (85.8%) and one-third was diagnosed with fibrosis F4. Among the rescue pangenotypic regimens, the most commonly used was the sofosbuvir/velpatasvir (SOF/VEL) ± ribavirin (RBV) combination. The sustained virologic response, which was a measure of treatment effectiveness, was achieved by 102 patients, resulting in cure rate of 90.3% in the per protocol analysis. All 11 non-responders were infected with GT1b, 7 were diagnosed with cirrhosis, and 9 were treated with SOF/VEL±RBV. We demonstrated the high effectiveness of the pangenotypic rescue options in patients after genotype specific NS5A-containing regimens failures, identifying cirrhosis as a negative prognostic factor of treatment effectiveness. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0)
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Review

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12 pages, 784 KiB  
Review
Hepatitis C Elimination: Opportunities and Challenges in 2023
by Gadeer Taha, Levy Ezra and Naim Abu-Freha
Viruses 2023, 15(7), 1413; https://doi.org/10.3390/v15071413 - 22 Jun 2023
Cited by 5 | Viewed by 2464
Abstract
Hepatitis C Virus (HCV) infection is a leading etiology of liver cirrhosis and its associated complications, namely, decompensated cirrhosis. As such, hepatitis C potentially necessitates liver transplantation and may result in death. Recently, HCV treatment has evolved. Current HCV treatment is effective in [...] Read more.
Hepatitis C Virus (HCV) infection is a leading etiology of liver cirrhosis and its associated complications, namely, decompensated cirrhosis. As such, hepatitis C potentially necessitates liver transplantation and may result in death. Recently, HCV treatment has evolved. Current HCV treatment is effective in curing HCV; some of the agents are pan-genotypic. Numerous countries have adopted an initiative to eliminate HCV. Achieving elimination poses many challenges; it requires improved availability and accessibility of pan-genotypic therapy. Barriers exist at the level of the collective healthcare system and at the level of the individual healthcare providers and patients. Therefore, organized national and local efforts are needed. Surmounting these barriers calls for interventions concerning screening, linkage to care, and treatment delivery. Pertinent barriers include inadequate availability of screening, ill-equipped laboratory testing before treatment, and insufficient access to treatment. Interventions should seek to decentralize laboratory testing and treatment provision, increase funding for resources and personnel, and spread awareness. Special consideration should be allocated to at-risk populations, such as intravenous drug users, refugees, and prisoners. Computerized medical filing and telemedicine have the potential to refine HCV management by enhancing detection, availability, accessibility, and cost-effectiveness. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0)
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Other

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11 pages, 3689 KiB  
Systematic Review
Prevention of Viral Hepatitis and HIV Infection among People Who Inject Drugs: A Systematic Review and Meta-Analysis
by Yen-Ju Chen, Yu-Chen Lin, Meng-Tien Wu, Jenn-Yuan Kuo and Chun-Hsiang Wang
Viruses 2024, 16(1), 142; https://doi.org/10.3390/v16010142 - 18 Jan 2024
Viewed by 1082
Abstract
This study aimed to explore the current evidence on preventing blood-borne virus infections among people who inject drugs (PWID). We conducted a comprehensive search across three databases (PubMed, Embase, Cochrane Library) for relevant articles published in English between 2014 and 2023. We followed [...] Read more.
This study aimed to explore the current evidence on preventing blood-borne virus infections among people who inject drugs (PWID). We conducted a comprehensive search across three databases (PubMed, Embase, Cochrane Library) for relevant articles published in English between 2014 and 2023. We followed the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines, assessed the quality of the paper using the revised Cochrane Risk of Bias Tool (ROB 2), and conducted a meta-analysis using RevMan 5.3. Completing the harm reduction program (HRP) participation and receiving all three vaccine doses resulted in a 28% reduction in the risk of HBV infection (OR: 0.72, 95% CI: 0.37–1.42). Various interventions increased the willingness of PWIDs to undergo HCV treatment (OR: 5.91, 95% CI: 2.46–14.24) and promoted treatment adherence (OR: 15.04, 95% CI: 2.80–80.61). Taking PrEP, participating in HRP, and modifying risky behaviors were associated with a 33% reduction in the risk of HIV infection (OR: 0.67, 95% CI: 0.61–0.74). Conducting referrals, providing counseling, and implementing antiretroviral therapy resulted in a 44% reduction in the risk of viral transmission (OR: 0.56, 95% CI: 0.47–0.66). Co-infection may potentially compromise effectiveness, so it is important to consider drug resistance. Full article
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat 2.0)
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