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Advances in Hepatitis: Prevention, Treatment, and Global Health Impact

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 3023

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Special Issue Editors

Dr. Michał Brzdęk

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Guest Editor

Department of Infectious Diseases, Jan Kochanowski University, Żeromskiego 5, 25-369 Kielce, Poland.
Interests: HCV; hepatitis c; HBV; hepatitis B; covid-19; sars-cov-2; microbiome; MASLD

Prof. Dr. Dorota Zarębska-Michaluk

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Department of Infectious Diseases, Jan Kochanowski University Kielce, Kielce, Poland
Interests: hepatitis; hepatitis B; hepatitis C; liver disease
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Dr. Krystyna Dobrowolska

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Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
Interests: hepatitis; hepatitis B; hepatitis C; liver disease

Special Issue Information

Dear Colleagues,

Hepatitis continues to pose a substantial global health challenge, despite remarkable advancements in its prevention, diagnosis, and treatment. The advent of direct-acting antivirals (DAAs) has revolutionized hepatitis C therapy, yielding cure rates above 95%, while effective vaccination programs have curbed the spread of hepatitis B. However, inequities in access to care, particularly in low- and middle-income countries, hinder progress toward global elimination goals. This Special Issue aims to highlight innovative strategies in prevention, novel therapeutic developments, public health initiatives, and policy approaches addressing viral hepatitis. We welcome original research and reviews that explore molecular mechanisms, clinical trials, epidemiological trends, and health equity efforts. Our shared objective is to support global efforts aligned with the WHO’s 2030 targets and ultimately reduce the burden of liver disease worldwide.

Dr. Michał Brzdęk
Prof. Dr. Dorota Zarębska-Michaluk
Dr. Krystyna Dobrowolska
Guest Editors

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Keywords

hepatitis B
hepatitis C
liver disease
direct-acting antivirals (DAAs)
global health
public health policy
viral hepa-titis elimination
health disparities
cirrhosis
vaccination programs

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Published Papers (4 papers)

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Research

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11 pages, 284 KB

Open AccessArticle

Screening Program for Asymptomatic Hepatitis C: Uptake and Detection in the Marche Region of Italy

by Cecilia Acuti Martellucci, Sara Rosati, Matteo Fiore, Mosè Martellucci, Silvia Bizzarri, Margherita Morettini, Lucia Marinelli, Gianmarco Imperiali, Romina Fani, Francesca Brecciaroli, Silvia Scaramuzza, Jacqueline Orciani, Fabio Filippetti and Lamberto Manzoli

J. Clin. Med. 2026, 15(8), 3057; https://doi.org/10.3390/jcm15083057 - 16 Apr 2026

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Abstract

Objectives: To report the performance of a screening program for undiagnosed HCV infections in the general population of one Italian region. Methods: The Marche region, central Italy, provided organized free HCV screening for the resident population born between 1969 and 1989, from July 2023 to December 2025. People with known liver disease or HCV treatment were excluded, and those eligible were invited by letter to access the blood draw. After a positive anti-HCV test, a reflex HCV-RNA test was performed on the same sample. The investigated outcomes were extension, uptake, HCV-RNA detection rate, and positive predictive value (PPV) of the anti-HCV test. Potential predictors of an infection diagnosis were investigated through multivariable analyses. Results: Over 30 months, 412,897 individuals were invited (93.6% extension), and 48,596 participated (11.8% uptake). Positive tests were 308 for anti-HCV (0.63%) and 42 for HCV-RNA (0.09% detection rate), with a relatively low PPV of the anti-HCV test (13.6%), which increased in males (15.2%) and individuals born in specific foreign countries (>20%). Multivariate analyses confirmed a higher risk of a positive HCV-RNA test for males (adjusted odds ratio—OR: 2.21; 95%CI 1.45–3.38) and those born in Moldova, Ukraine, and Pakistan (adjusted ORs between 10 and 15; p ≤ 0.001). Conclusions: The low detection rate was consistent with other Italian studies, suggesting that a combination of opportunistic recruitment and tailored pathways is required for high-risk groups in order to achieve the WHO HCV elimination targets. Future analyses should assess linkage-to-care and therapy compliance to evaluate the long-term cost–benefit ratio. Full article

(This article belongs to the Special Issue Advances in Hepatitis: Prevention, Treatment, and Global Health Impact)

14 pages, 654 KB

Open AccessArticle

Treatment with Direct-Acting Antivirals in Patients with HCV Infection After Liver Transplantation

by Michał Brzdęk, Dorota Zarębska-Michaluk, Olga Tronina, Łukasz Laurans, Ewa Janczewska, Dorota Dybowska, Anna Parfieniuk-Kowerda, Magdalena Tudrujek-Zdunek, Jolanta Białkowska-Warzecha, Justyna Janocha-Litwin and Robert Flisiak

J. Clin. Med. 2026, 15(1), 346; https://doi.org/10.3390/jcm15010346 - 2 Jan 2026

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Abstract

Background/Objectives: Direct-acting antivirals (DAAs) have revolutionized the management of chronic hepatitis C virus (HCV) infection. However, real-world data on the effectiveness and safety of DAA therapy in patients with history orthotopic liver transplantation (OLTx) remain limited. This study aimed to evaluate the clinical characteristics, effectiveness, and safety of DAA therapy in liver transplant recipients with chronic hepatitis C in a nationwide, real-world cohort. Methods: A retrospective analysis was performed of all consecutive adult patients who underwent OLTx before starting DAA therapy between July 2015 and December 2024 within the EpiTer-2 project, which included 20,586 patients treated because of chronic hepatitis C. Results: A total of 141 patients participated in the study, with most of them being men (66%) and aged 50 years or older. Most patients (80%) had comorbidities, and nearly a quarter of the population had cirrhosis of the transplanted liver at the start of antiviral therapy. The median time from OLTx to initiation of antiviral therapy was 24 months. Overall, SVR was achieved in 96.4% of patients in the intention-to-treat analysis and in 98.6% after excluding patients lost to follow-up. The treatment was well tolerated. Serious adverse events were reported in five patients. During DAA treatment and 12 weeks of follow-up after treatment, two deaths were reported. Subgroup analysis by time from OLTx to antiviral therapy (≤24 vs. >24 months) revealed no differences in effectiveness and safety despite some baseline clinical variations. Conclusions: DAA therapy in liver transplant recipients with chronic HCV infection is highly effective and well-tolerated. Full article

(This article belongs to the Special Issue Advances in Hepatitis: Prevention, Treatment, and Global Health Impact)

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14 pages, 452 KB

Open AccessArticle

Prevalence and Trends in Active Smoking Among Adults Living with HCV in the U.S. over the Last Decade: A Population-Level Analysis

by Mohammad Alabbas, Jingyi Shi, Yuqi Guo, Hongke Wu, Ibukunoluwa Oshobu, Maria Castano, Walaa Mahmoud, Shreya Sengupta and Omar T. Sims

J. Clin. Med. 2025, 14(18), 6671; https://doi.org/10.3390/jcm14186671 - 22 Sep 2025

Viewed by 996

Abstract

Background: Smoking in patients with hepatitis C (HCV) amplifies the risk of cirrhosis and hepatocellular carcinoma. We aimed to estimate the prevalence of active smoking over the last decade at the population level among adults living with HCV in the U.S., estimate temporal trends in active smoking, and identify factors associated with active smoking. Methods: We analyzed repeated cross-sectional NHANES data (2007–2018) of adults ≥20 years old with serologic evidence of HCV and complete smoking data (unweighted [n = 621] and weighted [n = 3,620,603] sample size). Temporal trends were evaluated using linear regression and joinpoint regression. Survey-weighted multivariable logistic regression was used to identify factors associated with active smoking. Results: The cumulative prevalence of active smoking was 56.4% (95% CI, 49.2–63.4). Linear trend testing was not significant (p = 0.93). Joinpoint regression suggested a slope change near 2013–2014, but neither segment-specific annual percent changes nor the slope change reached significance. Factors associated with higher odds of active smoking included female sex (aOR = 2.23; 95% CI, 1.17–4.24), low poverty income ratio (aOR = 3.33; 1.41–7.84), lifetime substance use (aOR = 10.63; 3.08–36.70), and depression (aOR = 2.65; 1.29–5.45). Lower odds were observed with >high-school education (aOR = 0.50; 0.26–0.94), obesity (aOR = 0.32; 0.18–0.58), and ≥2 yearly healthcare visits (aOR = 0.27; 0.10–0.68). Conclusions: Smoking appears to be endemic within the HCV population, and rates have remained alarmingly high and stagnant (i.e., unchanged or have not decreased) over the last decade, which consequently can lead to heightened incident cases of HCV-related cirrhosis and hepatocellular carcinoma in the near future. Full article

(This article belongs to the Special Issue Advances in Hepatitis: Prevention, Treatment, and Global Health Impact)

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Review

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14 pages, 1370 KB

Open AccessReview

Hepatitis E in Thailand: From Seroprevalence to Foodborne and Transfusion-Associated Risks

by Yong Poovorawan, Sitthichai Kanokudom, Pornjarim Nilyanimit and Jiratchaya Puenpa

J. Clin. Med. 2026, 15(8), 2837; https://doi.org/10.3390/jcm15082837 - 9 Apr 2026

Viewed by 343

Abstract

Background: Hepatitis E virus (HEV) is an increasingly recognized cause of acute viral hepatitis in Thailand as the burden of hepatitis A, B, and C has declined. HEV is a positive-sense RNA virus in the family Hepeviridae with three major open reading frames encoding replication proteins (ORF1), the capsid protein (ORF2), and an accessory protein involved in viral egress (ORF3). Unlike highly endemic regions where genotypes 1 and 2 are linked to waterborne outbreaks, infections in Thailand are reported mainly as sporadic cases associated with zoonotic transmission, most commonly genotype 3. Objectives: This review summarizes the epidemiology, transmission routes, and public health implications of HEV infection in Thailand. Methods: Peer-reviewed studies on HEV seroprevalence, molecular epidemiology, and transmission in Thailand were identified through PubMed using combinations of the keywords “HEV” and “Thailand”. Two investigators independently screened titles, abstracts, and full texts. Eligible studies were synthesized qualitatively. Results: Earlier studies suggested low population exposure, but more recent evidence indicates substantial cumulative risk. A nationwide survey among blood donors reported anti-HEV IgG seroprevalence of about 30%, with geographic variation and increasing prevalence with age. Detection of HEV RNA in pigs, slaughterhouse environments, and retail pork products, together with links to raw or undercooked pork consumption, supports pigs as the principal reservoir and foodborne exposure as an important route. Transfusion-associated infection has also been documented. Conclusions: In Thailand, HEV infection is linked mainly to zoonotic and foodborne transmission involving genotype 3. Stronger surveillance, food safety measures, and risk-based blood safety policies are needed. Full article

(This article belongs to the Special Issue Advances in Hepatitis: Prevention, Treatment, and Global Health Impact)

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