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35 pages, 3406 KB  
Review
Therapeutic Vaccines for Chronic Viral Infections: From Immune Modulation to Clinical Translation
by Zhuang Li, Yuan Zhang, Yiyang Zheng, Hongyu Wang, Chenyang Xu and Qing He
Vaccines 2026, 14(6), 507; https://doi.org/10.3390/vaccines14060507 - 4 Jun 2026
Viewed by 620
Abstract
Therapeutic vaccines are a key strategy to achieve the goal of “functional cure” of chronic viral infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human papillomavirus (HPV), and Epstein–Barr virus (EBV). Various platforms (such as viral vectors, [...] Read more.
Therapeutic vaccines are a key strategy to achieve the goal of “functional cure” of chronic viral infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human papillomavirus (HPV), and Epstein–Barr virus (EBV). Various platforms (such as viral vectors, nucleic acid vaccines, recombinant proteins, etc.) have successfully induced strong virus-specific T-cell responses in early trials, but their clinical efficacy is still limited by the immunosuppressive environment formed by the host. The core bottlenecks are severe T-cell exhaustion, viral immune escape, and various forms of local immune tolerance. Therefore, the field is moving toward combination therapies, including reduction of viral load, targeting of immune activation, and inhibition of inhibitory signaling pathways. This article summarizes the preclinical and clinical progress of therapeutic vaccines in the past decade, analyzes the major challenges in vaccine development, and discusses the future development directions in this field. Full article
(This article belongs to the Special Issue Vaccine Design and Development)
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40 pages, 2203 KB  
Article
Serological and Molecular Epidemiology of Hepatitis B, C, and D Viruses in Northwest Russia: A Population-Based Cross-Sectional Study
by Anna Y. Popova, Yulia V. Ostankova, Alesia Y. Olkhovskaya, Olga A. Petrova, Alexandr N. Shchemelev, Elena N. Serikova, Svetlana A. Egorova, Diana E. Reingardt, Irina V. Drozd, Ojuna B. Zhimbaeva, Ekaterina M. Danilova, Angelica M. Milichkina, Elena B. Ezhlova, Albina A. Melnikova, Natalia S. Bashketova, Lidiya V. Buts, Edward S. Ramsay and Areg A. Totolian
Viruses 2026, 18(6), 632; https://doi.org/10.3390/v18060632 - 30 May 2026
Viewed by 558
Abstract
The hepatitis B (HBV), C (HCV), and D (HDV) viruses remain a major public health burden. Occult HBV infection (OBI) represents a hidden reservoir with clinical and epidemiological significance, yet its prevalence in Northwest Russia is unknown. We aimed to comprehensively assess the [...] Read more.
The hepatitis B (HBV), C (HCV), and D (HDV) viruses remain a major public health burden. Occult HBV infection (OBI) represents a hidden reservoir with clinical and epidemiological significance, yet its prevalence in Northwest Russia is unknown. We aimed to comprehensively assess the serological and molecular epidemiology of HBV, HCV, and HDV in St. Petersburg and the Leningrad region. Methods. In this cross-sectional study, 6773 apparently healthy volunteers were enrolled. Plasma samples were tested for hepatitis B surface antigen (HBsAg), antibodies to HBV core antigen (anti-HBc), antibodies to HBsAg (anti-HBs), antibodies to HCV (anti-HCV), and antibodies to HDV (anti-HDV) by ELISA. All anti-HCV- and anti-HDV-positive samples were tested for HCV RNA and HDV RNA by real-time PCR. All samples were tested for HBV DNA using a highly sensitive in-house nested real-time PCR assay (detection limit: 5 IU/mL). All “HBV DNA-positive, HBsAg-negative” cases confirmed by two independent extractions were classified as OBI. Vaccination status, self-reported history, and iatrogenic interventions were recorded. Results. Overall seroprevalence values were: HBsAg 1.7%; anti-HBc 11.3%; anti-HBs 43.0%; anti-HCV 1.9%; and anti-HDV 0.6%. Anti-HBc increased sharply with age (3.1% in children to 26.4% in the elderly, p < 0.0001), while anti-HBs declined (69.9% to 29.8%, p < 0.0001). HBV DNA was detected in 118 participants (1.7%). Of these, only 73 individuals (1.1%) were HBsAg-positive, while the remaining 45 participants (0.7%) had undetectable HBsAg, meeting the criteria for OBI. OBI was detected across all age groups, including children. Serological profiling of OBI cases revealed that 57.8% lacked both anti-HBc and anti-HBs, 35.6% had isolated anti-HBs, 2.2% had isolated anti-HBc, and 4.4% had both antibodies. HCV RNA was detected in 15.0% of anti-HCV-positive individuals (all adults). No HDV RNA was detected. Self-reported history underestimated true infection rates: 1.4% of those denying HBV infection were HBsAg-positive and 10.6% were anti-HBc-positive. Among those denying HCV infection, 1.4% were anti-HCV-positive. Vaccination coverage was 70.8%, declining from 90.9% in children to 39.0% in the elderly (p < 0.0001). Among vaccinated individuals, 48.0% lacked protective anti-HBs (<10.0 mIU/mL). Conclusions. This comprehensive serological and molecular study in Northwest Russia is the first to combine population-level serology with molecular detection of HBV, HCV, and HDV, including OBI in this region, and reveals that OBI accounts for a substantial proportion (38%) of all active HBV infections and is strongly associated with a history of iatrogenic interventions. The presence of OBI across all age groups, including children, shows that HBsAg screening alone substantially underestimates the true HBV burden. High rates of unrecognized infection and waning vaccine-induced immunity, highlight critical gaps in current surveillance. These findings provide an evidence-based rationale for integrating molecular testing into screening algorithms and for considering booster vaccination strategies to achieve viral hepatitis elimination goals. Full article
(This article belongs to the Section Human Virology and Viral Diseases)
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19 pages, 3537 KB  
Article
Mapping Determinants of Hepatitis C Virus E1/E2 Transmembrane Interactions Using Intergenotypic Chimeras
by Margherita Fanalista, Christina Holmboe Olesen, Rodrigo Velázquez-Moctezuma, Jens Bukh and Jannick Prentoe
Viruses 2026, 18(6), 616; https://doi.org/10.3390/v18060616 - 28 May 2026
Viewed by 634
Abstract
Hepatitis C virus (HCV) infection remains a major global health burden, and no vaccine preventing chronic infection is available. The envelope glycoproteins, E1 and E2, form a complex essential for viral entry; however, the mechanisms governing E1/E2 assembly and stability remain incompletely defined. [...] Read more.
Hepatitis C virus (HCV) infection remains a major global health burden, and no vaccine preventing chronic infection is available. The envelope glycoproteins, E1 and E2, form a complex essential for viral entry; however, the mechanisms governing E1/E2 assembly and stability remain incompletely defined. Here, we investigated the role of the E1/E2 transmembrane (TM) regions in HCV infectivity using chimeras of JFH1-based recombinants with isolate-specific Core-NS2 sequences in which the C-terminal TM domains of E1 (TME1), E2 (TME2), or both (TME1E2) from the H77 isolate (genotype 1a) replaced those of isolates representing genotypes 1–6. We further introduced the TM domains of S52 (genotype 3a) or J6 (genotype 2a) into H77 and included reciprocal swaps between J6 and S52. Most TM-swap chimeras displayed impaired infectivity; however, serial passaging led to partial recovery associated with adaptive mutations in E1/E2 mapping not only to the C-terminal TM regions but also to the E1 stem and the internal E1 TM region (iTME1). Extending the TME1 swap to include upstream α-helical segments improved infectivity in selected chimeras, whereas inclusion of iTME1 abolished infectivity. These findings support functional interactions between membrane-associated regions of E1/E2 and their ectodomains and highlight their relevance for E1/E2-based HCV vaccine design. Full article
(This article belongs to the Special Issue Innovations and Emerging Challenges in Hepatitis C Virus Research)
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12 pages, 956 KB  
Article
Hepatitis B in Hemodialysis: Serologic Dynamics and Implications for Care
by Rawi Hazzan, Nana Peleg, Tarek Saadi, Mahmood Mahajna, Maanit Shapira, Yana Tal, Ahlam Bsoul, Oren Gal and Fadi Abu Baker
J. Clin. Med. 2026, 15(8), 2950; https://doi.org/10.3390/jcm15082950 - 13 Apr 2026
Viewed by 713
Abstract
Background: Hemodialysis patients are particularly vulnerable to hepatitis B virus (HBV) due to immunosuppression and repeated vascular access. While universal childhood vaccination has reduced population-level HBV prevalence, dialysis units require tailored prevention and monitoring strategies. This study aimed to characterize HBV serologic [...] Read more.
Background: Hemodialysis patients are particularly vulnerable to hepatitis B virus (HBV) due to immunosuppression and repeated vascular access. While universal childhood vaccination has reduced population-level HBV prevalence, dialysis units require tailored prevention and monitoring strategies. This study aimed to characterize HBV serologic profiles, evaluate immune responses, and assess the kinetics of antibody waning in a diverse hemodialysis population. Methods: We retrospectively analyzed 565 adult hemodialysis patients (2015–2024), assessing HBV seroprevalence, seroconversion, booster response, and antibody waning. Subgroup comparisons were made by ethnicity and birth cohort (pre- vs. post-1992 national vaccine rollout). Time-to-waning analyses were performed using Kaplan–Meier methods. Results: HBsAg and anti-HBc were positive in 4.1% and 31.7% of patients, respectively; 3.7% were HCV seropositive. No HBsAg seroconversions occurred, and 2.1% of initially anti-HBc-negative patients seroconverted. Among patients with isolated anti-HBc, 80.9% developed protective anti-HBs titers, and none became HBsAg- or HBV DNA-positive. Waning anti-HBs titers occurred in 67.5% (median: 7.3 months), with 87.4% demonstrating a serologic response following documented vaccine delivery. Patients born after 1992 showed higher isolated anti-HBs positivity and lower anti-HBc prevalence. Ethnic subgroup analysis showed higher exposure rates but similar booster response among minority patients. Conclusions: HBV serologic profiles in this hemodialysis cohort reflected the interplay of immunosuppression, vaccination practices, and evolving epidemiologic trends. Subgroups exhibited variable vaccine responses, differing patterns of antibody waning, and a low incidence of new infections. These findings support tailored, population-specific HBV monitoring and prevention strategies in dialysis care. Full article
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14 pages, 737 KB  
Article
SARS-CoV-2 Infection and COVID-19 Vaccine Antibody Responses in Two Canadian Cohorts of Persons Living with HIV
by Sharon L. Walmsley, Leif Erik Lovblom, Bryan Boyachuk, Curtis Cooper, Valérie Martel-Laferrière, Mona Loutfy, Marie-Louise Vachon, Shariq Haider, Pamela Aldebes, Karen Colwill, Anne Claude Gingras, Freda Qi and Marina B. Klein
Antibodies 2026, 15(2), 30; https://doi.org/10.3390/antib15020030 - 3 Apr 2026
Viewed by 1215
Abstract
Objectives: To determine the incidence and outcomes of SARS-CoV-2 infection and to evaluate seroconversion rates and quantify antibody responses to COVID-19 vaccines in two cohorts of persons living with HIV at a possible higher risk of poor outcomes (HCV coinfection and those over [...] Read more.
Objectives: To determine the incidence and outcomes of SARS-CoV-2 infection and to evaluate seroconversion rates and quantify antibody responses to COVID-19 vaccines in two cohorts of persons living with HIV at a possible higher risk of poor outcomes (HCV coinfection and those over the age of 65 years). Methods: We included participants from two established cohorts of persons living with HIV, those who were older than 65 years of age, and those with hepatitis C (HCV) co-infection. Four hundred and seventy-one participants completed questionnaires on SARS-CoV-2 infection and COVID-19 vaccine doses and submitted peripheral blood specimens for measuring antibody levels to COVID-19 antigens, full-length spike trimer, its receptor binding domain (RBD), and nucleocapsid protein (N) at 6-month intervals up to three visits between February 2021 and December 2024. Logistic and ordinal logistic regression models evaluated predictors of seroconversion and antibody levels. Results: Overall, 51% of participants developed a SARS-CoV-2 infection, but it was mild, with only nine requiring hospital admission and no deaths. Overall, 99% of tested specimens had antibodies above threshold to either spike or RBD proteins. Specimens that did not and those with lower antibody levels had testing earlier in the pandemic, and were from participants with fewer vaccine doses, and did not have natural infection. Age, depression, comorbidity, HCV co-infection, current substance use, CD4 count, or HIV viral load were predictive of antibody level. Those with hybrid immunity had higher antibody responses. Conclusions: In cohorts of persons with HIV-HCV coinfection and those who are ageing, we observed high rates of seroconversion to COVID-19 antigens. Antibody levels were higher among those with more vaccine doses, hybrid immunity, and later in the pandemic waves. Although 51% developed a breakthrough infection, outcomes were mild with no deaths. Full article
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28 pages, 1192 KB  
Review
RNA Therapeutics in Viral Infections and Cancer: Mechanisms, Challenges, and Prospects: A Review
by Evgenii Generalov, Alexei Shevelev, Dmitry Romanov, Olga Tarasova and Natalia Pozdniakova
Pharmaceutics 2026, 18(4), 431; https://doi.org/10.3390/pharmaceutics18040431 - 31 Mar 2026
Viewed by 1786
Abstract
Background: RNA therapeutics represent a rapidly advancing field with significant potential for treating viral infections and cancer. This review examines the current landscape of RNA-based strategies, including siRNA, miRNA mimics, and antisense oligonucleotides. For viral infections, the focus is on hepatitis B [...] Read more.
Background: RNA therapeutics represent a rapidly advancing field with significant potential for treating viral infections and cancer. This review examines the current landscape of RNA-based strategies, including siRNA, miRNA mimics, and antisense oligonucleotides. For viral infections, the focus is on hepatitis B (HBV) and C (HCV), HIV, and SARS-CoV-2. Approaches include targeting viral transcripts directly (e.g., siRNAs against HBV surface antigen) or host factors critical for viral replication (e.g., anti-miR-122 miravirsen for HCV). The successful development of mRNA vaccines for COVID-19 is highlighted as a major breakthrough, demonstrating the feasibility of rapid RNA vaccine deployment. The manuscript reviews several RNA therapeutics in oncology that have reached clinical trials. These include TargomiR (a miR-16 mimic for mesothelioma), cobomarsen (an anti-miR-155 for lymphomas), and MRX34 (a miR-34a mimic for various solid tumours). The review also covers emerging candidates like an miR-221 inhibitor and various strategies for breast cancer, such as targeting Bcl-2, KRAS, and specific miRNAs. A critical challenge across both fields is developing efficient and safe delivery systems, including lipid nanoparticles, GalNAc conjugates, and bacterial minicells. Despite promising preclinical results, clinical translation has been hampered by issues like insufficient delivery efficiency to human tumours, toxicity, and the complex, interconnected regulatory networks of miRNAs, which can lead to unpredictable off-target effects. Conclusions: While RNA therapeutics hold immense promise, overcoming delivery barriers and enhancing understanding of RNA regulatory networks are essential for future success. Full article
(This article belongs to the Section Gene and Cell Therapy)
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14 pages, 245 KB  
Article
HBV and HCV Burden in a Greek Hospital Population (2018–2024): Trends and Correlates of HBsAg and Anti-HCV Positivity
by Nikolaos Georgiadis, Christina Seitopoulou, Maria Kimouli, Theodoros N. Sergentanis, Apostolos Beloukas and Georgina Tzanakaki
Pathogens 2026, 15(3), 342; https://doi.org/10.3390/pathogens15030342 - 23 Mar 2026
Viewed by 827
Abstract
Background: Hepatitis B and C remain a major public health challenge in Greece, particularly amid demographic shifts, migration, and evolving socioeconomic conditions. Updated epidemiological data are essential to guide public health planning and prevention strategies. Methods: A repeated cross-sectional study was [...] Read more.
Background: Hepatitis B and C remain a major public health challenge in Greece, particularly amid demographic shifts, migration, and evolving socioeconomic conditions. Updated epidemiological data are essential to guide public health planning and prevention strategies. Methods: A repeated cross-sectional study was conducted among adults (n = 36,085) attending the General Hospital of Nikaia “Agios Panteleimon”, Piraeus, Greece, from 2018 to 2024. Participants consisted of inpatients and outpatients, including recognized high-risk groups. Serological markers assessed current hepatitis B infection (HBsAg) and past or recent hepatitis C exposure (anti-HCV). Associations were examined using univariate and multivariate logistic regression, reporting adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: Overall prevalence was 4.65% for HBsAg (n = 1677) and 6.6% for anti-HCV (n = 2378). Females had significantly lower odds compared to males for both markers (HBsAg aOR = 0.24, anti-HCV aOR = 0.77, both p < 0.001). Anti-HCV prevalence declined with age, with the ≥70 group showing the lowest odds (aOR = 0.24, p < 0.001). For HBsAg, older age groups also showed reduced odds, particularly ages 60–69 (aOR = 0.49, p < 0.001) and ≥70 (aOR = 0.75, p = 0.005). Compared to Attica region, most regions had significantly lower odds of both infections, including Thrace (HBsAg aOR = 0.08; anti-HCV aOR = 0.32, both p < 0.001), Crete (HBsAg aOR = 0.13; anti-HCV aOR = 0.35, both p < 0.001), and Macedonia (HBsAg aOR = 0.37; anti-HCV aOR = 0.64, both p < 0.001). Compared to 2018, the odds were markedly higher in 2023 and peaked in 2024 for both infections (anti-HCV aOR = 1.78; HBsAg aOR = 3.10, both p < 0.001 for 2024). High-risk social groups demonstrated substantially elevated odds of anti-HCV (aORs 3.9–5.51, all p < 0.001), but had lower odds of HBsAg (aORs 0.32–0.60, all p ≤ 0.001). Conclusions: Increasing prevalence trends, regional disparities, and pronounced differences among vulnerable groups highlight the urgent need for strengthened screening, vaccination, and targeted hepatitis B and C prevention strategies, particularly among healthcare-attending and high-risk populations in Greece. Full article
13 pages, 377 KB  
Article
Identification of Unrecognized Hepatitis B, C, and D Infections Through the Private Laboratory-Based RE-LINK Screening Project in Romania: A Micro-Elimination Initiative
by Liliana Gheorghe, Antoanela Curici and Speranta Iacob
Livers 2026, 6(1), 13; https://doi.org/10.3390/livers6010013 - 20 Feb 2026
Viewed by 949
Abstract
Background/Objectives: Chronic hepatitis B (HBV) and C (HCV) remain major public health challenges in Romania despite vaccination and antiviral therapy. Understanding infection patterns in different healthcare settings is essential for targeted elimination strategies. Methods: We conducted the prospective screening phase of [...] Read more.
Background/Objectives: Chronic hepatitis B (HBV) and C (HCV) remain major public health challenges in Romania despite vaccination and antiviral therapy. Understanding infection patterns in different healthcare settings is essential for targeted elimination strategies. Methods: We conducted the prospective screening phase of the RE-LINK project (January–June 2025) through two nationwide private laboratory networks. Adults undergoing routine testing were screened for HBsAg and anti-HCV. HBsAg-positive samples were further analyzed for HBV DNA, HBeAg, anti-HBe, anti-HDV, and HDV RNA, while anti-HCV-positive cases were tested for HCV RNA. Risk factors were assessed using chi-square and logistic regression analyses. Results: Among 9149 individuals (66.6% women with a median age of 53 years), HBsAg prevalence was 2.9%, and anti-HCV was 1.3%, both increasing significantly with age (p < 0.001). Of all HBsAg-positive individuals, 12.5% had undetectable HBV DNA, 70.4% had low viremia (<2000 IU/mL), and 17.1% had high viral loads. Anti-HDV antibodies were detected in 2.3% of HBsAg-positive subjects, all with detectable HDV RNA (range 1250–680,000 IU/mL). Significant risk factors for HBsAg positivity were male sex, older age, urban residence, physician-indicated testing, neuropsychiatric comorbidity, family or parental hepatitis, and institutional/orphanage care, while HBV vaccination and moderate alcohol use were protective. Anti-HCV positivity correlated with older age, cardiovascular disease, elevated transaminases, transfusions, surgery, and HIV co-infection. Only 20.2% of anti-HCV-positive individuals were viremic. Conclusions: Private-laboratory screening reveals residual low-replicative HBV and declining viremic HCV, while community programs uncover HDV and advanced disease in vulnerable groups. A coordinated approach integrating private, community, and hospital-based pathways can accelerate elimination efforts and ensure that HDV is not overlooked. Full article
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22 pages, 3540 KB  
Article
Targeted Removal of HCV E2 N2 N-Glycan Is Associated with Improved Immune Responses in Mice
by Yuan-Qin Min, Yu-Shan Ren, Wen-Wen Zhang, Yi-Dan Zhou and Min Liu
Biomolecules 2026, 16(2), 183; https://doi.org/10.3390/biom16020183 - 24 Jan 2026
Viewed by 793
Abstract
Hepatitis C virus (HCV) still lacks a licensed vaccine. The envelope glycoprotein E2 is a key neutralizing target, but its dense N-glycan shield can hinder epitope exposure. In this study, we revisit E2 glycan editing and examine whether single-site deletion preserves antigen integrity [...] Read more.
Hepatitis C virus (HCV) still lacks a licensed vaccine. The envelope glycoprotein E2 is a key neutralizing target, but its dense N-glycan shield can hinder epitope exposure. In this study, we revisit E2 glycan editing and examine whether single-site deletion preserves antigen integrity while improving immune responses in mice under a DNA immunization setting. Using a secreted E2 ectodomain (sE2384–661), we generated five N to D mutants at conserved sites (N1, N2, N4, N6, and N11) and evaluated them in a unified DNA immunization model with identical CpG content and delivery conditions across groups. The N2 mutant (N423, sE2-N2) maintained expression, secretion, and ER localization; furthermore, in mice, it was associated with higher anti-E2 titers and greater inhibition of H77 (genotype 1a) HCVcc at the tested dilutions, with limited activity against Con1 (1b). Cellular analyses showed increased IFN-γ ELISPOT counts and higher frequencies of granzyme B+/perforin+ CD8+ T cells after N2 immunization, while IL-4 remained low. Functionally, N2 elicited stronger specific lysis of CT26-sE2 targets in vitro and slowed CT26-sE2 tumor growth in vivo. In HCV-infected ICR4R+ mice, therapeutic vaccination with sE2-N2 reduced blood HCV RNA and hepatic readouts compared with sE2. A monoclonal antibody isolated from sE2-N2-immunized mice (1C1) neutralized HCVcc in vitro and, after passive transfer, lowered viremia and liver signals in infected mice. Collectively, these findings indicate that selective removal of the N2 glycan preserves antigen properties and is associated with improved humoral and cellular immunity and measurable in vivo activity, supporting targeted glycan editing as a practical strategy to refine E2-based HCV vaccines. Full article
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32 pages, 1753 KB  
Review
Vaccination Strategies Against Hepatic Diseases: A Scoping Review
by Zahra Beyzaei, Bita Geramizadeh, Sara Karimzadeh and Ralf Weiskirchen
Vaccines 2026, 14(1), 49; https://doi.org/10.3390/vaccines14010049 - 31 Dec 2025
Cited by 2 | Viewed by 2170
Abstract
Background/Objectives: Viral hepatitis remains a significant global cause of chronic liver disease, highlighting the importance of effective vaccination strategies. This review assesses recent evidence on vaccine safety and effectiveness. Methods: A comprehensive search of PubMed, Embase, Web of Science, and Scopus [...] Read more.
Background/Objectives: Viral hepatitis remains a significant global cause of chronic liver disease, highlighting the importance of effective vaccination strategies. This review assesses recent evidence on vaccine safety and effectiveness. Methods: A comprehensive search of PubMed, Embase, Web of Science, and Scopus identified English-language studies published from January 2000 to September 2025. Eligible studies evaluated vaccination for hepatitis A, B, C, or E, as well as vaccine responses in individuals with chronic liver disease or HIV infection. Of 5254 records screened, 166 studies met the inclusion criteria. Results: Hepatitis A vaccines demonstrated excellent safety, 95–100% short-term seroprotection, and durable immunity for both inactivated and live-attenuated formulations, with population-level reductions in disease incidence. Hepatitis B vaccines showed consistently strong immunogenicity across age groups, with over 90% seroprotection from recombinant and CpG-adjuvanted formulations. Effective prevention of mother-to-child transmission required maternal antiviral therapy, timely birth-dose vaccination, hepatitis B immunoglobulin (HBIG) administration, and post-vaccination serologic testing. Long-term data demonstrated immune persistence for up to 35 years and significant reductions in liver cancer following neonatal HBV vaccination. Limited studies in hepatitis C populations showed impaired responses, partially improved with higher or booster doses. Hepatitis E vaccines showed excellent safety and over 99% seroconversion. In non-viral liver disease and post-transplant populations, vaccine responses were reduced but remained clinically meaningful, especially with adjuvanted or higher-dose HBV vaccines. Among HIV-infected individuals, HAV vaccination was generally effective, while enhanced HBV regimens markedly improved seroprotection. Conclusions: Hepatitis A, B, and E vaccines are safe, immunogenic, and effective, with neonatal hepatitis B vaccination critical for preventing maternal transmission. No licensed HCV vaccine exists, and therapeutic HCV vaccines show limited efficacy. Optimized and targeted vaccination strategies are needed for individuals with chronic liver disease, HIV infection, HCV infection, transplant recipients, and other immunocompromised populations to maximize public health impact. Full article
(This article belongs to the Special Issue Vaccination and Public Health in the 21st Century)
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18 pages, 410 KB  
Article
Epidemiological and Clinical Profile of Hemoglobinopathies and Thalassemia in Duhok, Kurdistan Region of Iraq: A Retrospective Study
by Burhan Abdullah Zaman, Zuhair Rushdi Mustafa, Delshad Abdulah Mohamed, Hasan Abdullah Aswad and Deldar Morad Abdulah
Thalass. Rep. 2025, 15(4), 12; https://doi.org/10.3390/thalassrep15040012 - 28 Nov 2025
Viewed by 2518
Abstract
Background/Objectives: Thalassemia is among the most common hereditary disorders globally, characterized by impaired hemoglobin synthesis and ineffective erythropoiesis. This study analyzed data on hemoglobinopathies, with a particular focus on thalassemia, to support the development of a comprehensive national database and to improve understanding [...] Read more.
Background/Objectives: Thalassemia is among the most common hereditary disorders globally, characterized by impaired hemoglobin synthesis and ineffective erythropoiesis. This study analyzed data on hemoglobinopathies, with a particular focus on thalassemia, to support the development of a comprehensive national database and to improve understanding of the disease burden in the Kurdistan Region of Iraq. Methods: In this retrospective cross-sectional study, a total of 910 patients admitted to the region’s sole blood disorder center since its establishment were included. Results: The study analyzed 46.7% male and 53.3% female thalassemia patients in Duhok, with 58.46% reporting parental consanguinity. Hepatitis C virus (HCV) prevalence was 11.87%, while 8.90% underwent bone marrow transplantation (BMT) and 30.11% had splenectomies. Blood group distribution was O+ (36.26%), A+ (30.99%), and B+ (18.46%). Common medications included Deferasirox (34.62%), Hydroxyurea (26.70%), and Deferoxamine (5.82%), with 8.24% and 4.40% discontinuing Deferasirox and Hydroxyurea, respectively. Geographically, 29% of the patients originated from Duhok City, which exhibited a consanguinity rate of 18.65% (p = 0.020). The most prevalent conditions were β-thalassemia major (32.53%) and sickle cell anemia (24.73%). HCV-positive patients were predominantly diagnosed with β-thalassemia major (43.40%) and sickle cell anemia (33.96%). BMT recipients were mostly β-thalassemia major patients (80.25%), while splenectomy was common in β-thalassemia major (43.40%) and sickle cell β-thalassemia (22.64%). Vaccination rates included Pneumococcal (50.78%), Influenza (47.76%), and Hepatitis (39.08%, first dose). Six patients (0.66%) died, with 30.18% diagnosed before age 1 and 43.89% between 1 and 2 years. In conclusion, this study underscores the high prevalence of β-thalassemia major and sickle cell anemia in Duhok, with strong associations to parental consanguinity and low socioeconomic status. Gaps in early diagnosis and vaccination coverage remain significant challenges. Full article
(This article belongs to the Section Quality of Life)
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24 pages, 3154 KB  
Review
Hepatitis Vaccines: Recent Advances and Challenges
by Mei Lu, Yakun Liu, Lele Li, Xueke Liu, Bin Wu and Yingping Wu
Vaccines 2025, 13(11), 1174; https://doi.org/10.3390/vaccines13111174 - 20 Nov 2025
Cited by 2 | Viewed by 3407
Abstract
Viral hepatitis constitutes a substantial global public health challenge. The etiological agents, referred to as hepatitis viruses, are primarily categorized into five types: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and hepatitis E virus [...] Read more.
Viral hepatitis constitutes a substantial global public health challenge. The etiological agents, referred to as hepatitis viruses, are primarily categorized into five types: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and hepatitis E virus (HEV). Among the various preventive strategies, vaccination is widely acknowledged as the most cost-effective and efficient method for controlling viral hepatitis and its related hepatic complications. To date, numerous countries have initiated extensive vaccination programs targeting hepatitis A and hepatitis B. Advances in biotechnology have facilitated substantial progress in vaccine formulation design, the development of innovative adjuvants, and the utilization of novel vectors. However, significant challenges persist, including inadequate vaccination coverage, inconsistent immune responses among vulnerable populations, and concerns regarding vaccine safety. This article presents a systematic review of recent advancements, the current status of vaccination efforts, and ongoing challenges associated with hepatitis vaccines, with the objective of providing critical insights to support the World Health Organization’s goal of eliminating viral hepatitis as a public health threat by 2030. Full article
(This article belongs to the Special Issue Vaccination Against Viral Hepatitis for Prevention and Treatment)
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30 pages, 3776 KB  
Systematic Review
Vertical Transmission of Hepatitis B and C—Then and Now—A Comprehensive Literature Systematic Review
by Ruxandra Dobritoiu, Daniela Pacurar, Raluca Maria Vlad and Doina Anca Plesca
Viruses 2025, 17(10), 1395; https://doi.org/10.3390/v17101395 - 20 Oct 2025
Cited by 2 | Viewed by 4698
Abstract
Background: According to a WHO global hepatitis report, the global prevalence of hepatitis B in 2022 was 254 million and for hepatitis C it was 50 million. The estimated number of people newly infected by viral hepatitis declined from 3 million in 2019 [...] Read more.
Background: According to a WHO global hepatitis report, the global prevalence of hepatitis B in 2022 was 254 million and for hepatitis C it was 50 million. The estimated number of people newly infected by viral hepatitis declined from 3 million in 2019 to 2.2 million in 2022. Of these, 1.2 million are hepatitis B infections and nearly 1.0 million are hepatitis C infections. Regarding vertical transmission, it is estimated that 4 to 5 million children are infected worldwide every year from HBV-positive mothers. The United States declared that hepatitis C is the commonest chronic blood-borne infection, with an increase in HCV birth infections from 1.8 to 4.7 per 1000 births. Objectives: This systematic review focuses on highlighting the most suitable screening methods and maternal interventions to prevent HBV/HCV mother-to-child transmission, as well as the appropriate prophylactic strategies for newborns. Materials and methods: We searched a medical database (PubMed) to find papers regarding mother-to-child transmission of hepatitis B and C. Inclusion criteria were human-based studies, studies with large cohorts of subjects, studies conducted in different parts of the globe and position papers from various international associations. Exclusion criteria were non-human-based studies and non-English publications. To present and synthesize results we made use of thematic analysis and narrative synthesis. Results: We included 103 publications. For hepatitis B, the combination of maternal antiviral therapy during pregnancy and timely administration of HBV vaccine alongside HBIG to the newborn has proven to be highly effective in lowering transmission rates. Hepatitis C vertical transmission lacks an effective vaccine or immuno-prophylaxis, turning prevention strategies into a continuous battle. Conclusions: Vertical transmission of hepatitis B and C continues to be a major contributor to the global burden of chronic viral hepatitis. Strengthening prenatal care programs, improving access to diagnostic and therapeutic resources and enhancing public health policies are essential to curb vertical transmission of both hepatitis B and C. Full article
(This article belongs to the Section Human Virology and Viral Diseases)
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15 pages, 1390 KB  
Article
Polyphosphazene-Mediated Assembly of TLR4 and TLR7/8 Agonists Enables a Potent Nano-Adjuvant Delivery System for Hepatitis C Virus Vaccine Antigens
by Alexander K. Andrianov, Alexander Marin, Sarah Jeong, Liudmila Kulakova, Ananda Chowdhury, Raman Hlushko, Sayan Das, Francesca Moy, Eric A. Toth, Robert K. Ernst and Thomas R. Fuerst
Vaccines 2025, 13(10), 1012; https://doi.org/10.3390/vaccines13101012 - 28 Sep 2025
Viewed by 1220
Abstract
Background: The quest for well-defined immunoadjuvants remains one of the highest priorities for the successful development of effective vaccines. Combination adjuvants, which are designed to integrate both the ability to activate a variety of immune mechanisms and synergistically improve the delivery of [...] Read more.
Background: The quest for well-defined immunoadjuvants remains one of the highest priorities for the successful development of effective vaccines. Combination adjuvants, which are designed to integrate both the ability to activate a variety of immune mechanisms and synergistically improve the delivery of vaccine components, are well-positioned to address the unmet needs. The development of a preventive vaccine against hepatitis C virus (HCV)—a major public health concern—is a particular instance in which the choice of the immunoadjuvant is of utmost importance. Methods: We assembled a lipid A Toll-like receptor 4 (TLR4) agonist BECC438 and TLR7/8 agonist resiquimod (R848) on a polyphosphazene macromolecule (PCPP) to create a nanoscale immunoadjuvant-vaccine delivery system: PCPP-R+BECC438. This aqueous-based system was formulated with the HCV sE2 antigen, and the resulting vaccine candidate was evaluated in vivo for the ability to induce immune responses. Results: Co-assembly of adjuvants resulted in a visually clear aqueous system of nanoscale dimensions, monomodal size distribution, and entropy-driven interactions between components. Intramuscular immunization of mice with HCV sE2 antigen formulated in a polyphosphazene-based nano-system induced ten-fold higher IgG and IgG2a titers than the antigen adjuvanted with BECC438 alone. PCPP-R+BECC438 formulated HCV sE2 also produced statistically significant improvements in IgG2a/IgG1 ratio and more robust HCVpp neutralization ID50 titers than control formulations. Conclusions: Polyphosphazene-assembled adjuvant nano-system promotes in vivo immune responses of enhanced quantity and quality of antibodies with increased potency of HCV neutralization. Full article
(This article belongs to the Section Hepatitis Virus Vaccines)
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40 pages, 17153 KB  
Review
Immunotherapy of Oncovirus-Induced Cancers: A Review on the Development and Efficacy of Targeted Vaccines
by Chi Sing Ng
Vaccines 2025, 13(9), 911; https://doi.org/10.3390/vaccines13090911 - 27 Aug 2025
Viewed by 3188
Abstract
Background: A number of viruses are oncogenic. These include the human papilloma virus (HPV), Epstein–Barr virus (EBV), Kaposi sarcoma human herpes virus 2/human herpes virus 8 (KSHHV/HHV8), hepatitis B virus, (HBV), hepatitis C virus (HCV), Merkel cell polyoma virus (McPyV), and the human [...] Read more.
Background: A number of viruses are oncogenic. These include the human papilloma virus (HPV), Epstein–Barr virus (EBV), Kaposi sarcoma human herpes virus 2/human herpes virus 8 (KSHHV/HHV8), hepatitis B virus, (HBV), hepatitis C virus (HCV), Merkel cell polyoma virus (McPyV), and the human T-cell leukemia virus type 1 (HTLV-1). These viruses cause malignancies ranging from carcinomas, sarcomas, lymphomas, to leukemias. This review aims to study the effects and efficacy of vaccines against these viruses and the cancers they cause in their prevention and treatment. Methods: The literature in the past 30 years was searched employing Scopus and Google Scholar using the keywords “oncogenic viruses, HPV, EBV, KSHHV, HHV8, Polyoma virus, HTLV-1, COVID-19, carcinoma, sarcoma, lymphoma, leukemia, anti-virus vaccines”. Results: Prophylactic vaccines against the HPV and HBV are highly effective in preventing and reducing the incidence of uterine cervical and hepatocellular carcinomas. Prophylactic vaccines against other oncogenic viruses have been less successful, though efficacious in some experimental animals. Therapeutic vaccines are still mostly under evaluation and development. Conclusions: Identification of oncogenic viruses has rendered anti-viral vaccines conspicuous tools for preventing and treating cancers they cause. Many endeavors for the development of such vaccines have been met with limited success, apart from the very effective anti-HPV and anti-HBV vaccines in universal vaccination programs. With the development of new vaccine technologies, it is hoped that effective vaccines against other oncogenic viruses will be developed in the future. Full article
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