If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.

A recent study suggested that hepatitis B virus (HBV)-DNA testing should be considered routinely in monitoring drug-induced liver injury, and also in other clinical implications associated with occult hepatitis B virus infection.

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Age and hepatitis B virus DNA viral load were independent predictors of significant liver damage in HBeAg-negative chronic hepatitis B patients with persistently normal serum alanine aminotransferase, according to a study in Turkey.

German researchers said that stopping or interrupting treatment with nucleos(t)ide analogues in noncirrhotic patients with HBeAg-negative chronic hepatitis B should be further investigated as a strategy to accelerate HBsAg loss.

Despite its high variability, the hepatitis C virus (HCV) is under strict evolutionary constraints, most probably to keep its genes and proteins functional during the replication cycle, according to a study in Virus Evolution.

The high burden of chronic hepatitis B virus infection in Asian countries is a major challenge for the incorporation of national programs to prevent chronic HBV complications within health care systems, according to a meta-analysis in the International Journal of Infectious Diseases.

Recent research suggests that a transition to newer direct acting antivirals is urgently needed in Rwanda and sub-Saharan Africa more generally to improve treatment outcomes for hepatitis C virus–infected patients.

Ribavirin is an effective treatment for hepatitis E virus (HEV) infection, according to a recent review study, but further studies are required to determine which other antiviral agents are of clinical utility in treating HEV in the minority of patients who do not respond to ribavirin.

Robust HEV-specific T-cell responses generated during acute disease predominantly target open reading frame 2 (ORF2), according to a study in Hepatology, but decline in magnitude and polyfunctionality over time. The authors said that defining HEV T-cell targets will be important for the investigation of HEV-associated autoimmune disease.

A recent study indicated that the variability in estimates of spontaneous viral clearance of hepatitis C virus infection – between HIV-positive men who have sex with men and people who inject drugs – has an impact on HIV coinfection and HCV reinfection.

A French study found that the rate of patients failing to return for the results of HIV, HBV, HCV, and syphilis testing is a problem, but the use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis.

In chronic hepatitis C virus infection, the preferential association of HCV with B cells is mediated by the complement system, mainly through complement receptor 2 (CD21), in conjunction with the CD19 and CD81 complex, according to a study in Hepatology.

An Italian study found that virological response at week 8 of pegylated interferon and ribavirin therapy in hepatitis C–infected children could be considered a reliable predictor of sustained virologic response.

A recent study found that interferon treatment increased, rather than decreased, hepatitis C virus long double-stranded RNA (dsRNA) in patients. The authors said this unexpected finding suggests that HCV produces dsRNA in response to interferon, potentially to antagonize antiviral defenses.

A vaccine study in Argentina found that single-dose universal hepatitis A immunization in 1-year-old children resulted in sustained immunologic protection for up to 9 years.

A Japanese study found that CD14⁺ monocyte-derived galectin-9 increases NK cell cytotoxicity in chronic hepatitis C virus infection, which might be associated with liver injury and persistent infection.

Sofosbuvir and ribavirin for 6 weeks was not effective among people with recent hepatitis C virus infection, according to results from the DARE-C II study.

A study in Hepatology found that a single broadly neutralizing antibody can prevent acute hepatitis C virus infection without inducing the emergence of resistance-associated variants (RAVs), and may complement direct-acting antivirals to reduce the emergence of RAVs.

Vaccination with DTPa-HBV-IPV/Hib (diphtheria-tetanus-acellular pertussis–hepatitis B–inactivated poliovirus/Haemophilus influenza type b) in infancy induces sustained seroprotection and immune memory against hepatitis B virus, a recent study found, as revealed by the strong anamnestic response to the hepatitis B vaccine challenge in 12- to 13-year-old adolescents.

Chronic hepatitis C virus infection appears to disrupt the milieu of soluble inflammatory mediators even after viral clearance, investigators found, indicating HCV cure does not lead to complete immunological restitution.

Among the largest U.S. community-based real-world cohort of Asian chronic hepatitis C virus genotype 6 patients treated with all-oral sofosbuvir/ledipasvir without ribavirin, sustained viral response at 12 weeks was similar to SVR12 reported in clinical trials, validating current HCV genotype 6 treatment guideline recommendations.

Lower serum albumin and higher AST appear to be important mortality risk factors in HIV/HCV-coinfection, but much less so in HIV-monoinfected individuals, reported a study in the journal AIDS.

A retrospective study of 11 European pediatric HIV cohorts found a high proportion of patients coinfected with hepatitis C virus and suffering from progressive liver disease, which investigators said underscores the need for close monitoring and for earlier and more effective HCV treatment.

Chinese investigators have developed and validated a novel classification and regression tree (CART) analysis model that they say is superior to the model for end-stage liver disease (MELD) for predicting 3-month mortality of patients with acute-on-chronic hepatitis B liver failure.

A study in Lancet Infectious Diseases confirmed that injection drug use is a major contributor to the global burden of disease for HIV, hepatitis C, and hepatitis B.

rpizzi@frontlinemedcom.com

On Twitter @richpizzi

Hepatitis Outlook: September 2016