Hepatitis C Virus Research Articles

Impact of COVID-19 on key populations and people living with HIV: recommendations and sociopolitical responses from the EPIC community research program in Latin America

BackgroundHealth inequality in Latin America is particularly severe for individuals living with HIV (PLHIV) and key populations, such as men who have sex with men, transgender women, people who use drugs, and sex workers. Despite regional programs aimed at reducing health inequalities, such as the Sustainable Development Goals and the Sustainable Health Agenda for the Americas 2018–2030, the COVID-19 health crisis has exposed significant shortcomings in national healthcare systems for PLHIV and key populations. The multi-country, community-based research program, EPIC, was developed by Coalition PLUS within an network of community-based organizations engaged in the response to HIV and viral hepatitis. The EPIC program aimed to study the impact of the COVID-19 health crisis on 1) key populations (KP) and/or PLHIV or hepatitis C; 2) community health workers (CHWs) and peer educators; and 3) key innovations and adaptations in HIV/HCV services. The objective of this article is to highlight main issues faced in the region during the COVID-19 health crisis in order to inform national and international policies.MethodsA general protocol and study materials were developed and included built-in flexibility to allow participating organizations to adapt the study to local needs in terms of target populations and specific areas of interest. Data were collected through surveys and/or interviews. In total 118 studies were conducted across 31 countries: 66 quantitative (n = 12,060 among KP or PLHIV or people living with HCV and n = 811 among CHWs) and 52 qualitative (n = 766 among KP or PLHIV or people living with HCV and n = 136 among CHWs).DiscussionFindings in Latin America highlight the difficulties faced by PLHIV and KP in accessing health services, as well as issues of discrimination, violence, and mental health challenges, all of which have been exacerbated by the health crisis. Additionally, the study highlights strategies implemented by community CHWs and peer educators to mitigate the negative impact of the crisis. Moreover, EPIC demonstrates the ability of community agents to generate scientific evidence that raises public awareness of the situation faced by the most vulnerable populations.ConclusionNational and international policies must recognize and support the unique capacity of CHWs and peer educators to adapt health interventions to the specific needs of communities. Policymakers are also urged to involve the community in the development of public policies aimed at reducing inequalities and improving the living conditions of vulnerable populations.

Project HCV Connect: Using a County Surveillance Registry to Link Hepatitis C Virus-Infected Residents to Cure—Los Angeles County, April 2023 to March 2024

Los Angeles County has a high prevalence of chronic hepatitis C virus (HCV) infection, but resources and infrastructure to notify and increase treatment uptake among county residents are absent. Through an innovative academic-public partnership, we developed a linkage-to-cure program utilizing the Department of Public Health’s HCV surveillance registry. Case workers contacted reported cases via phone, to offer education, and treatment referral. Three months after the initial communication, individuals that reported that they were untreated were recontacted to evaluate treatment status. Between April 2023 and March 2024, a total of 639 individuals with HCV were interviewed; 84% of them were aware of their infection status, and 70% were untreated. Among those interviewed three months after initial communication (n = 260), 22% started or completed treatment and 30% were under evaluation for treatment. Leveraging existing resources and new partnerships Public Health Departments could mobilize individuals to seek medical care and lead the effort towards elimination of HCV.

Abstract A036: Comparison of immunotherapies response in hepatocellular carcinoma HCC with viral hepatitis vs non-viral hepatitis

Abstract Background: Hepatocellular carcinoma (HCC), the most common liver cancer, accounts for 80% of diagnosed cases. Immunotherapy is increasingly used for advanced HCC and other solid tumors. Approximately 13% of cancers are associated with infections. HCC etiology varies by regionally, with 54% of cases in Asia and sub-Saharan Africa due to hepatitis B, while hepatitis C is more common in Italy and Japan. Hepatitis infections disrupt liver signaling, causing inflammation and abnormal cell regeneration. In HCC progression, inflammation serves as a “double-edged sword.” While chronic inflammation is a significant driver of tumor development and immune evasion, it can also promote tumor cell death, either directly through ferroptosis or indirectly by enhancing anticancer immune responses, thereby potentially inhibiting HCC progression. This study aimed to evaluate immunotherapy response in HCC associated with viral hepatitis compared to non-viral hepatitis. Methods: HCC patients were analyzed using data from the cBioPortal database, from a cohort study of hepatobiliary cancers. Only HCC patients who received nivolumab, pembrolizumab, atezolizumab, bevacizumab, durvalumab, tremelimumab, ipilimumab, ramucirumab, or daratumumab, either as monotherapy or in combination were included. We excluded all cases of cholangiocarcinoma (CCA), HCC with CCA, and those not treated with immunotherapy. We calculated median overall survival (OS) for immunotherapy-treated HCC patients with viral hepatitis compared to those with non-viral hepatitis. Survival analysis was conducted using the Kaplan–Meier (KM) method. Results: Among 1,370 hepatobiliary cancer cases, 289 were identified as HCC. After excluding patients who did not receive immunotherapy, a total of 101 cases remained, of which 56 (55.4%) had viral HCC, and 45 (44.6%) had non-viral HCC. Most patients were white 62 (61%), and 27 (26%) had cirrhosis. Additionally, 66 (65%) had TERT mutations, 45 (43%) had TP53 mutations. Of the total, 52 (51%) had died, while 49 (48%) were still alive. All patients received at least one immunotherapy cycle, with 65 (64.4%) receiving it as a palliative setting. Viral HCC was associated with a median OS of 60 months (95% CI,38.24-NA), while non-viral HCC showed median OS of 40 months (95% CI,25.34-NA) (p=0.106). Conclusion: Our study highlighted that HCC patients with underlying viral infections achieve better outcomes from immunotherapy, evidenced by a longer OS compared to patients with non-viral HCC. This suggests that viral HCC may have a unique tumor biology or immune environment that enhances the response to immunotherapy, leading to improved survival outcomes relative to non-viral cases. Citation Format: Saifudeen Abdelrahim, Ebtesam Al-Najjar, Bayan Khasawneh, Abdullah Esmail, Ala Abudayyeh. Comparison of immunotherapies response in hepatocellular carcinoma HCC with viral hepatitis vs non-viral hepatitis [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Functional and Genomic Precision Medicine in Cancer: Different Perspectives, Common Goals; 2025 Mar 11-13; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2025;85(5 Suppl):Abstract nr A036.

Hepatitis C virus transmission among people who inject drugs in rural United States: mathematical modeling study using stochastic agent-based network simulation (AJE-00824-2024).

People who inject drugs (PWID) account for the majority of hepatitis C virus (HCV) infections in the United States. The injection-equipment-sharing network likely plays an important role in shaping the dynamics of HCV transmission. Recognizing the emerging HCV epidemic in rural communities, we developed an agent-based network simulation model of HCV transmission via injection-equipment-sharing and used data on rural PWID networks to inform model parameterization and calibration. We then simulated an array of networks that varied key network properties to understand their impact on the magnitude and distribution of HCV incidence. The results show substantial heterogeneity in HCV acquisition risks across the network, summarized using the Ghyaini coefficient. In addition, although PWID with fewer injection partners had lower incidence, they collectively acquired more infections due to their larger population size. Higher prevalence, average number of partners, and homophily in HCV infection were associated with lower heterogeneity in infection risk across the network and higher overall incidence; other network properties including population size did not have a substantial impact. Our findings illustrate the heterogeneity of HCV transmission among PWID and suggest key network properties that could be measured, evaluated, or considered in the design of interventions for PWID in future studies.

The challenge of treating hepatitis C virus infection in children with comorbidities

Direct-acting antivirals (DAAs) have revolutionized hepatitis C virus (HCV) treatment and enabled the treatment of those who could not be treated using interferon. The aim of this work was to assess the efficacy and safety of oral DAAs in HCV-infected children with associated comorbidities. This analytical retrospective study included children with HCV mono-infection versus those with associated comorbidities. The study included 187 HCV-infected children aged 6–18 years; 114 patients (61%) had associated comorbidities. The most frequent comorbidities were hematological disorders (30.7%), followed by renal and cardiac diseases. Baseline total bilirubin, aspartate aminotransferase, and gamma glutamyl transpeptidase were significantly more elevated in patients with comorbidities. Sustained virologic response (SVR) was achieved in 100% of patients with HCV mono-infection versus 98.2% of patients with comorbidities. The most frequently reported treatment adverse effects were headache, asthenia, and irritability. All side effects were transient and did not necessitate treatment discontinuation. Conclusion: DAAs allowed treatment of HCV-infected children with comorbidities with high SVR and excellent safety profile. Treatment with sofosbuvir/ledipasvir achieved an SVR of 98.9% in HCV-infected children with comorbidities. Treatment was safe and well tolerated with mild transient adverse events.What is Known:• The novel DAAs have revolutionized the landscape of HCV treatment and enabled the treatment of those who could not be treated using IFN.• When treating HCV, clinicians should take into consideration the presence of other comorbid conditions.In the IFN-RBV era, many HCV patients with comorbidities were ineligible for therapy.What is New:• There are limited data in the literature about the efficacy and tolerability of DAAs in children with comorbidities.• We reported in the current study that DAAs allowed treatment of HCV-infected children with comorbidities with high SVR and excellent safety profile. These patients should be offered treatment with oral DAAs to help decrease the infectious pool and hence reach the ambitious final goal of global eradication.

Time series analysis and scaling law characteristics of viral hepatitis from 2004 to 2023 in Zhejiang Province, China.

Hepatitis significantly increases the global disease burden and has become a major public health issue worldwide. China is a high-risk area for viral hepatitis, which is also a serious public health problem. The scaling relationship between various types of hepatitis and population size was explained by a scaling law. Fixed-effects and random-effects meta-analyses were used to calculate a combined index of β based on the single-scale index from 2004 to 2023. Furthermore, the X11 process was employed to identify the structural components of the time series of various types of hepatitis. In the past 20 years, the proportion of patients with viral hepatitis in Zhejiang Province has changed significantly, and hepatitis B remains the main type of hepatitis, accounting for approximately 70% of all hepatitis cases. The proportion of hepatitis C and E cases has been increasing, whereas the proportion of hepatitis A cases has been decreasing since 2004 and has remained at a low level (approximately 3%) since 2010. The combined scaling exponents of hepatitis A, hepatitis B, hepatitis C, hepatitis E and unclassified hepatitis based on the random effects model were 0.88 (95% confidence interval(CI): 0.78 to 0.98), 0.78 (95% CI: 0.70 to 0.86), 1.18 (95% CI: 1.11 to 1.26), 0.91 (95% CI: 0.86 to 0.97) and 0.89 (95% CI: 0.79 to 1.00), respectively. In the past 20 years, the epidemic situation of hepatitis A, hepatitis B and unclassified hepatitis has shown a significant downward trend, whereas the proportions of hepatitis C and hepatitis E among those with viral hepatitis have increased annually. The combined scaling exponent and development trends of the five types of hepatitis show significant heterogeneity. Overall, hepatitis C exhibits superlinear characteristics, whereas other types of hepatitis exhibit sublinear characteristics. Different types of hepatitis exhibit distinct epidemic characteristics and require targeted prevention and control measures.

Disparities in Health Care in Patients With Chronic Liver Disease

Chronic liver disease (CLD) is increasing in prevalence worldwide. CLD has significant associated morbidity and mortality, including a negative impact on health-related quality of life (HRQOL), progression to cirrhosis, development of hepatocellular carcinoma (HCC), and need for liver transplantation. CLD disproportionately impacts racial, ethnic, sexual, and gender minorities. CLD is also more prevalent in populations experiencing challenging social determinants of health (SDOH) factors. Health disparities are prevalent across various forms of CLD, reflected in higher disease prevalence and severity, premature or excess adverse clinical outcomes and worse patient-reported outcomes. In this review, we highlight current epidemiology and health disparities across major forms of CLD, including metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-associated liver disease (ALD), viral hepatitis, and autoimmune liver disease. Herein we discuss challenges with respect to disparities in screening, diagnosis, noninvasive testing for risk stratification, treatment, and rates of clinical outcomes. We outline actionable interventions from a broad public health level to the individual patient level with the goal of moving towards health equity. Lastly, we highlight areas in need of future research that can inform future interventions to achieve health equity.

A Comprehensive Analysis of Cirrhosis Progression through Clinical Data

Cirrhosis is a progressive liver disease characterized by liver fibrosis and scarring, which can eventually lead to liver failure. It is primarily caused by chronic alcohol con- sumption, viral hepatitis, and non-alcoholic fatty liver disease (NAFLD). Early detection and diagnosis are crucial for pre- venting the progression of the disease. Recent advancements in machine learning and deep learning techniques have shown great promise in enhancing the diagnostic accuracy of cirrhosis through non-invasive methods, such as medical imaging analysis and biomarker prediction. These techniques aid in early-stage detection, ultimately improving patient prognosis and manage- ment. This paper explores various methods of cirrhosis detection, with a focus on artificial intelligence applications that automate diagnosis, enabling clinicians to make better-informed decisions. DOI:https://doi.org/10.52783/pst.1622

Genotypic Diversity of Hepatitis C Virus in Tuberculosis Patients in the Tomsk Region

Relevance. People with tuberculosis (TB) are at an increased risk of spreading parenteral viral hepatitis, including hepatitis C virus (HCV). Hepatitis C in tuberculosis patients can often be detected only as a result of laboratory tests. Some of the anti-tuberculosis drugs have a pronounced hepatotoxic effect, which can lead to severe liver damage, especially in cases of combined TB and HCV infection.Aim. Determination of genotypic diversity and molecular genetic characteristics of HCV isolates isolated from patients infected with tuberculosis in the Tomsk region.Materials and methods. The study was conducted on 117 blood serum/plasma samples obtained from patients infected with tuberculosis. The identified HCV isolates were genotyped by amplifying a fragment of the core gene in two-round PCR followed by determination of the nucleotide sequences of the resulting amplicons. Viral load was determined by quantitative RT-PCR.Results and discussion. The following distribution of subtypes in the studied sample was revealed: 1b (47.0%; 95% CI: 38.2–56.0), 3a (32.5%; 95% CI: 24.7–41.3), 1a (18.0%; 95% CI: 12.1–25.8) and recombinant 2k/1b (2.5%; 95% CI: 0.9–7.2). Among the variants of subtype 1b, polymorphisms in the core gene were identified, associated with resistance to interferon treatment: among 35 isolates, the L91M mutation was detected (63.6%; 95% CI: 31.4–56.7), substitutions at position R70Q were detected in 19 isolates /H (34.6%; 95% CI: 7.6–26.1). Both substitutions were found in 11 isolates (20.0%; 95% CI: 11.5–32.3). No differences were found in the distribution of subtypes between the four age groups (under 36, 36–40, 41–45, over 45). Significant differences were revealed (Pearson's χ² = 9.38; p = 0.025) in the distribution of subtypes between the examined men and women. In men, subtype 1b predominated, in women, subtype 3a predominated and there were practically no people infected with subtype 1a, unlike male patients.Conclusion. HCV research among tuberculosis-infected people is important for choosing the most appropriate treatment tactics for patients, preventing complications of co-infection, as well as for planning and implementing preventive measures.

Dental treatment needs and treatment frequency of inmates in basel.

The aim of this retrospective descriptive study was to identify the treatment frequency of prisoners and the associated need for dental treatment, as well as to analyse the associations between the DMFT index, general health conditions (mental health) and health behaviour (cigarette smoking). For this purpose, the medical records (secondary data) from 2018-2020 of 317 inmates receiving dental treatment from two Basel prisons were examined, categorized and statistically evaluated using linear regression models (RECORD 1.1, 1.2). At the time of the medical history, 87.1% of the inmates were taking at least one medication, 47.9% of them psychotropic drugs and 52.7% analgesics. 5.5% had a hepatitis C virus (HCV) infection. Opioid use correlated with HCV infection: 24.5% of opioid users (m/f) were also HCV+. Teeth had to be removed in 58.7% of inmates. The DMFT index was 1.85 times higher in smokers than in non-smokers. With each pack of cigarettes per day, the DMFT index increased 1.44-fold. The DMFT index in prisoners with mental illness was 1.5 times higher. Possible approaches to improve general and dental health include drug prevention, withdrawal therapy, sports promotion, dental health education and the provision of oral hygiene products. It is recommended that further studies be conducted with comprehensive examinations of inmates.

Risk of Cytomegalovirus Viremia Following Transplantation of Hepatitis C-Viremic Donor Kidneys Into Uninfected Recipients: A Multi-Center Retrospective Cohort Study.

Several studies have suggested an increased risk of cytomegalovirus (CMV) viremia among Hepatitis C virus (HCV)-uninfected recipients of kidney transplants from HCV-RNA+ deceased donors (HCV D+/R-), but these studies featured small sample sizes and limited ability to address confounding variables. We assembled a retrospective cohort of adult kidney transplant recipients at five US centers between 4/1/2015 and 12/31/2020 to determine the association between HCV D+/R- transplants and the outcomes of CMV viremia (>1000 IU/mL), death-censored graft failure, and mortality in the first posttransplant year compared to HCV D-/R- transplants. We generated highly similar matched cohorts of HCV D+/R- and HCV D-/R- recipients based on attributes that affect the risk of CMV viremia. We matched exactly on center, CMV donor/recipient serostatus, and antibody induction therapy. The cohort comprised 275 HCV D+/R- recipients with a mean age of 52.5 years (SD = 10.7); 19% were CMV D+/R-, and 74% received anti-thymocyte globulin induction. With variable ratio matching, 267 HCV D+/R- recipients were matched to 996 HCV D-/R- recipients. CMV viremia occurred in 15% of HCV D+/R- and 11% of HCV D-R- recipients. In Cox regression, transplantation with an HCV-RNA+ donor kidney was not associated with a significantly higher risk of CMV viremia (HR 1.3, 95% CI 0.89-1.92) or death-censored graft loss (HR 0.61, 95% CI 0.31-1.2). The risk of CMV viremia was not significantly increased among HCV D+/R- kidney recipients. Future studies should examine associations between donor-derived HCV infection and clinical outcomes of CMV syndrome and disease.

Predictors of Acute HCV Incidence in People with HIV: Insights from a Long-term Cohort Study.

Persons living with HIV (PWH) remain at risk for hepatitis C virus (HCV) acquisition despite antiretroviral therapy, particularly among those who inject drugs or engage in high-risk sexual behaviors. We evaluated acute HCV incidence and associated risk factors in PWH, incorporating sex-specific differences and the use of Nucleic Acid Testing (NAT) methods, which were not addressed in previous analyses. We assessed NAT-based HCV incidence from 1996-2011 in the ACTG ALLRT cohort, a long-term study of PWH after initiating antiretroviral therapy. Multivariable Poisson regression identified associations with self-reported injection drug use (IDU), and time-varying CD4+ count, HIV RNA level and increased ALT (grade ≥3). No sexual risk factors or non-IDU drug use data were available. Among 4,015 PWH (18% women, n=703) with an initial negative HCV antibody result, there were 18,150 person-years (PY) of follow-up. Forty-two participants seroconverted, an incidence of 0.23 per 100 PY (95% CI: 0.17, 0.31). Incidence was lower in females (n=2) versus males (n=40; 0.06 vs 0.27 per 100 PY; p=0.04). Seroconversion was associated with time-updated HIV RNA ≥400 copies/mL (RR 2.7, 95% CI 1.4-5.1, p=0.003), time-updated grade ≥3 ALT (RR 4.7, 95% CI 1.6, 13.4, p=0.005), and IDU (RR 6.3, 95% CI 2.7, 14.4, p<0.001). Our analysis showed that IDU history and unsuppressed HIV RNA were associated with HCV acquisition among PWH. Elevated ALT levels are consistent with the biology of acute/recent hepatitis and should trigger HCV RNA testing. These findings emphasize the need for targeted interventions to reduce HCV transmission risk in PWH.

The interplay of socio-demographic factors and disease prevalence: insights into malaria, Hepatitis B, and Hepatitis C in Lafia, Nasarawa State, Nigeria.

Infectious diseases, including malaria, Hepatitis B surface antigen (HBsAg), and Hepatitis C virus (HCV), remain significant public health concerns in developing regions like Lafia, Nasarawa State, Nigeria. Socio-demographic factors, such as gender, age, income level, and access to healthcare resources, have been shown to influence the prevalence and outcomes of these diseases. Despite their importance, there is limited research exploring the interrelationship between these infections and socio-demographic factors within this region. The study aims to investigate the prevalence of malaria, HBsAg, and HCV among patients in Lafia, Nigeria, and to examine the relationship between these infections and socio-demographic factors. Specifically, it seeks to identify correlations between demographic variables, clinical manifestations, and health behaviors, such as mosquito net usage and vaccination status. A cross-sectional design was employed, involving 264 patients from Lafia, Nasarawa State, Nigeria. Data were collected using structured questionnaires which were pretested in a previous study to gather demographic information, vaccination status, and clinical symptoms. Laboratory assessments confirmed the presence of malaria, HBsAg, and HCV. Statistical analysis, including correlations between socio-demographic factors and disease prevalence were analyzed, and used to identify associations between socio-demographic factors, clinical manifestations, and disease prevalence. Significant findings include a negative correlation between male sex and malaria infection (Pearson Correlation = -0.139, p = 0.024), a positive correlation between age and HCV prevalence (Pearson Correlation = 0.218, p < 0.001), and a negative correlation between the use of mosquito nets and malaria infection (Pearson Correlation = -0.231, p < 0.001). Additionally, HBsAg-positive individuals exhibited more pronounced clinical symptoms (Pearson Correlation = 0.173, p = 0.005), while higher income levels correlated with reduced mosquito net usage (Pearson Correlation = -0.144, p = 0.020). The study underscores the role of socio-demographic factors in shaping the prevalence of malaria, HBsAg, and HCV. This study highlights the interplay between socio-demographic factors and the prevalence of malaria, HBsAg, and HCV in Lafia, Nigeria. It underscores the importance of comprehensive public health interventions tailored to the specific needs of the population to reduce disease burden and improve health outcomes, including health education, to address socio-economic vulnerabilities and promote preventive measures such as mosquito net usage. Addressing these factors could mitigate the burden of infectious diseases in Lafia and similar regions.

Exploring the potential of direct-acting antivirals against Chikungunya virus through structure-based drug repositioning and molecular dynamic simulations.

Exploring the potential of direct-acting antivirals against Chikungunya virus through structure-based drug repositioning and molecular dynamic simulations.

Chronic Viral Hepatitis Screening Inequities Across Florida Federally Qualified Health Centers.

Examine racial and ethnic inequities in hepatitis C and B virus (HCV and HBV) screening across high-risk populations. Chronic HCV and HBV infections can lead to cirrhosis, hepatocellular carcinoma (HCC), and death. Despite universal screening recommendations, < 50% of US adults are tested for these viruses. Populations with lower socio-economic status experience higher rates of viral-related cirrhosis and HCC, which may be reduced through screening and treatment. This study analyzed data from 91,875 patients (2019-2021) at the Health Choice Network, a federally qualified health center in Florida. Logistic regression assessed the determinants of HCV and HBV screening, considering factors such as age, sex, language, and race/ethnicity. The study population was predominantly female, Hispanic, uninsured, and living below the federal poverty line. Overall, 61.7% had HCV screening, and 43.7% had HBV screening. Haitian Creole-speaking patients (aOR 1.67; 95% CI, 1.50-1.85), Asian (aOR 1.41; 95% CI, 1.26-1.58), Spanish-speaking Hispanic (aOR 1.38; 95% CI, 1.32-1.44), and English-speaking Hispanic patients (aOR 1.12; 95% CI, 1.07-1.18) had higher odds of HCV screening, compared to NH-Whites. Similarly, Haitian Creole-speaking (aOR 1.91; 95% CI, 1.73-2.12), Asian (aOR 1.50; 95% CI, 1.33-1.68), and Spanish-speaking Hispanic patients (aOR 1.23; 95% CI, 1.17-1.29) had higher odds of HBV screening. For an underserved population context, screening rates were above average, with higher prevalence among historically disadvantaged populations. However, rates remained suboptimal, particularly among NH-Whites, who account for the largest number of HCV-related liver cancers, often linked to injection drug use. Increasing screening, especially among NH-Whites and English-speaking Hispanics for HCV, is crucial for early diagnosis, treatment, and reducing severe liver disease risk, including cirrhosis and HCC.

HCV NS3/4A protease relocalizes CCTα to viral replication sites, enhancing phosphatidylcholine synthesis and viral replication

Positive-sense single-stranded RNA [(+)RNA] viruses constitute more than one-third of all virus genera, including numerous pathogens of clinical significance. All (+)RNA viruses reorganize cellular membranes from organelles to establish replication compartments (RCs). These RCs are thought to form a platform for membrane-associated replicases, in addition to protecting the viral RNAs from cytosolic innate immune signaling and RNA-degradation machinery. Previous work demonstrated that three families of (+)RNA viruses, namely Bromoviridae, Picornaviridae, and Flaviviridae, commonly induce the accumulation of phosphatidylcholine (PC) at their RCs. This phenomenon suggests a potential avenue for a broad-spectrum antiviral strategy targeting PC metabolism. Our study elucidates three key observations: i) hepatitis C virus (HCV) infection prompts the relocalization of CCTα, the rate-limiting enzyme in PC synthesis, to the RCs; ii) the enhancement of PC synthesis is contingent upon the protease activity of the NS3/4A protein; and iii) utilizing click chemistry, we demonstrate that HCV infection stimulates de novo PC synthesis at the viral replication site through the Kennedy pathway. These findings provide significant insights into the manipulation of lipid metabolism by HCV during RC formation, a mechanism likely conserved across various (+)RNA virus families.

Bacteriological Profile Isolated from Patients with Viral Hepatitis Diseases

Background: Three types of bacterial liver infections may be distinguished: granulomatous liver disease caused by bacteria, bacterial liver abscesses, and acute bacterial hepatitis. Numerous types of hepatic infections have been linked to a wide range of bacteria, and the liver is impacted by the infection process of numerous systemic bacterial diseases. Clinical manifestations, etiological agents, and treatment modalities substantially intersect. The majority of liver-damaging bacterial infections only manifest clinically and laboratory as secondary hepatitis. Aims of the study: To show the bacterial profile in viral hepatitis patients as a preliminary investigation at Diyala province. Methodology: Cross-sectional study Included (40) patients with clinically diagnosed viral hepatitis with in a period of 1st November 2023 to 30th March 2024. Those subjects were in patients at Baaquba Teaching Hospital in Diyala province, Blood and urine samples were collected from each subject. Results: All blood and urine samples obtained from individuals with viral hepatitis yielded positive findings at percentage 26 (65%) when subjected to bacterial culture. Regarding blood culture, 19 cases were positive bacterial culture. The predominant bacterium of Gram positive was Staphylococcus haemolyticus, and for Gram-negative was Pseudomonas aeroginosa. bacterial cultures were detected in 26 cases for urine culture Also, Staphylococcus haemolyticus was the predominant Gram-positive bacterial type in urine samples of viral hepatitis patients and E. coli was the predominant type for Gram negative bacteria. Conclusion: Bacterial infections were detected in viral hepatitis patients. Bacterial cultures were detected in 26 cases for urine culture Also, Staphylococcus haemolyticus was the predominant Gram-positive bacterial type in urine samples of viral hepatitis patients and E. coli was the predominant type for Gram negative bacteria.

Hematological indicators and serum claudin-3 as valuable indices for severity of HCV-related liver cirrhosis

Background and study aimCirrhosis of the liver occurs in two stages: compensated and decompensated. Increased intestinal permeability and bacterial translocation are the causes of systemic inflammatory response syndrome (SIRs), which may be linked to hepatic decompensation. Serum claudin-3 and hematological indices [mean platelet volume (MPV)/platelet ratio (MPR), red cell distribution width (RDW), red blood cell/lymphocyte ratio (RLR), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and red cell/lymphocyte ratio (RLR)] were evaluated in this study as possible indicators of decompensated liver cirrhosis (LC).Patients/materials and methodsTwenty healthy people and 80 patients who were admitted to the tropical medicine department of Alexandria Main University Hospital participated in our study. Group I comprised 50 patients with decompensated LC post-chronic hepatitis C virus (HCV) infection, group II included 30 patients with compensated LC related to HCV, and group III included 20 healthy individuals as the control group. Using established protocols, enzyme-linked immunohistochemical assay (ELISA) was used to assess serum claudin-3.ResultsComparing patients with decompensated LC to those with compensated LC and the control group, there was a statistically significant increase in serum claudin-3. Patients with decompensated LC had significantly higher NLR, MLR, RPR, and MPR than those with compensated LC (p < 0.05). Serum claudin-3, NLR, MLR, Child–Pugh, and model of end-stage liver disease (MELD) scores showed significant positive relationships (p < 0.05). Linear regression analysis was conducted including claudin-3, RDW, NLR, MPR, PLR, RPR, MLR, and RLR revealed that only the model using combined NLR and claudin-3 was a statistically significant predictor of decompensation. Consequently, the ROC curve analysis for NLR and serum claudin-3 yielded a 90% sensitivity, 62% specificity, a diagnostic accuracy of 68% for NLR at a value of 2.27, while a diagnostic sensitivity of 80%, specificity of 60%, and a 72.5% diagnostic accuracy for claudin-3 at a cut-off value of 16.57 ng/L for diagnosing decompensated LC.ConclusionsNLR and serum claudin-3 are promising markers for monitoring the progression of LC.

Integrating CT Radiomics and Clinical Features to Optimize TACE Technique Decision-Making in Hepatocellular Carcinoma

Background/Objectives: To develop a decision framework integrating computed tomography (CT) radiomics and clinical factors to guide the selection of transarterial chemoembolization (TACE) technique for optimizing treatment response in non-resectable hepatocellular carcinoma (HCC). Methods: A retrospective analysis was performed on 151 patients [33 conventional TACE (cTACE), 69 drug-eluting bead TACE (DEB-TACE), 49 degradable starch microsphere TACE (DSM-TACE)] who underwent TACE for HCC at a single tertiary center. Pre-TACE contrast-enhanced CT images were used to extract radiomic features of the TACE-treated liver tumor volume. Patient clinical and laboratory data were combined with radiomics-derived predictors in an elastic net regularized logistic regression model to identify independent factors associated with early response at 4–6 weeks post-TACE. Predicted response probabilities under each TACE technique were compared with the actual techniques performed. Results: Elastic net modeling identified three independent predictors of response: radiomic feature “Contrast” (OR = 5.80), BCLC stage B (OR = 0.92), and viral hepatitis etiology (OR = 0.74). Interaction models indicated that the relative benefit of each TACE technique depended on the identified patient-specific predictors. Model-based recommendations differed from the actual treatment selected in 66.2% of cases, suggesting potential for improved patient–technique matching. Conclusions: Integrating CT radiomics with clinical variables may help identify the optimal TACE technique for individual HCC patients. This approach holds promise for a more personalized therapy selection and improved response rates beyond standard clinical decision-making.

Risk Factors Evaluation and Antiviral Eradication Therapies Among HCV Infected Family Members of Northern Regions, Pakistan

Hepatitis C virus (HCV) poses a global health threat, often transmitted intra-familial. This study aims to assess HCV transmission within Pakistani households and identify associated risk factors. To analyze 125 household subjects for HCV infection prevalence, demographics, genotypes, and risk factors. We conducted a comprehensive analysis of 125 household subjects to determine HCV prevalence. Demographics, genotypes, and risk factors were carefully examined through rigorous data collection and statistical analysis. Of the 125 households surveyed, 57 tested positive for HCV, indicating a high prevalence rate. Within these households, 121 individuals were infected, with a slightly higher proportion of females (59.5%). The distribution of infections varied across regions, with Islamabad showing the highest prevalence at 56.14%. Among the infected individuals, offspring were significantly affected (42.1%), followed by spouses (29.8%) and siblings (28%). Genotype 3a emerged as the most prevalent strain. Risk factors contributing to intra-familial transmission included major surgeries, dental procedures, hospitalizations, and blood transfusions. Furthermore, sharing personal items such as blades and towels also posed significant risks. Intra-familial transmission is a key driver of HCV spread within Pakistani households. The study's findings underscore the urgent need for targeted interventions to control and prevent HCV transmission within familial settings. Strategies should focus on raising awareness about risk factors and promoting preventive practices. Additionally, The most effective outcomes in the current study were observed with the combination therapy of Sofosbuvir and Ribavirin, achieving an End of Treatment Response (ETR) of 73% and a Sustained Virologic Response (SVR) of 72%.