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Medicina
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Viral Hepatitis Research: Updates and Challenges
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Viral Hepatitis Research: Updates and Challenges

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (15 October 2023) | Viewed by 14679

Special Issue Editors

Dr. Endrit Shahini

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Guest Editor
Gastroenterology Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, Castellana Grotte, BA, Italy
Interests: hepatitis
Dr. Antonio Giovanni Solimando

E-Mail Website
Guest Editor
Guido Baccelli Unit of Internal Medicine, Department of Biomedical Sciences and Human Oncology, School of Medicine, Aldo Moro University of Bari, Bari, Italy
Interests: internal medicine; oncology; hematological malignancies; multiple myeloma; emergency
Special Issues, Collections and Topics in MDPI journals
Dr. Antonella Argentiero

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Guest Editor
Medical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II” of Bari, 70124 Bari, Italy
Interests: pancreatic cancer; pancreatic ductal adenocarcinoma; tumor microenvironment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is our pleasure to invite you to contribute to the upcoming Special Issue of Medicina, entitled “Viral Hepatitis Research: Updates and Challenges”. The aim of this issue is to review current knowledge on diagnostic and therapeutic hepatitis treatment strategies.

In recent years, measures to eradicate hepatitis B and D have been overshadowed by meaningful advances in hepatitis C therapies. Specifically, there is an ongoing effort to eliminate hepatitis C and meet WHO's ambitious targets by 2030. To meet this target, 90% of people with hepatitis B and/or C should be diagnosed, and 80% of those eligible for treatment should be cured or virally suppressed if they have hepatitis B.

Likewise, the negative impact of the COVID-19 pandemic, and the shift in focus to other viral infections, has endangered hepatitis services and, as a result, the elimination agenda.

Indeed, during this period, only several countries were able to estimate the proportion of people diagnosed with these hepatotropic viruses due to barriers impeding the availability and accessibility of standard healthcare testing services.

The aim of this issue is to catalyze debate on this hot topic and outline the recent advances in biomedical science and immunization approaches. This in turn will, we hope, assist in revitalizing elimination programs and provide care models that can be adapted and developed globally.

All manuscripts will be peer-reviewed in accordance with standard journal policies and procedures.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but not limited to) the following:

  • hepatitis B;
  • hepatitis C;
  • hepatitis D;
  • COVID-19;
  • epidemiology;
  • autoimmunity;
  • elimination programs;
  • antiviral treatments.

We look forward to receiving your contributions.

Sincerely,

Dr. Endrit Shahini
Dr. Antonio Giovanni Solimando
Dr. Antonella Argentiero
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hepatitis B
  • hepatitis C
  • hepatitis D
  • COVID-19
  • epidemiology
  • autoimmunity
  • elimination programs
  • antiviral treatments

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Published Papers (6 papers)

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Research

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10 pages, 3729 KiB  
Article
A Low Geriatric Nutritional Risk Index Is Associated with Low Muscle Volume and a Poor Prognosis among Cirrhotic Patients
by Hirayuki Enomoto, Yukihisa Yuri, Takashi Nishimura, Naoto Ikeda, Tomoyuki Takashima, Nobuhiro Aizawa, Mamiko Okamoto, Kohei Yoshihara, Ryota Yoshioka, Shoki Kawata, Yuta Kawase, Ryota Nakano, Hideyuki Shiomi, Shinya Fukunishi, Shinichiro Shinzaki and Hiroko Iijima
Medicina 2023, 59(12), 2099; https://doi.org/10.3390/medicina59122099 - 29 Nov 2023
Viewed by 1574
Abstract
Background and Objectives: The geriatric nutritional risk index (GNRI) is an easily calculable index that can be determined using three common clinical variables. The GNRI is suggested to be related to sarcopenia in cirrhotic patients. However, the relationship between the GNRI and [...] Read more.
Background and Objectives: The geriatric nutritional risk index (GNRI) is an easily calculable index that can be determined using three common clinical variables. The GNRI is suggested to be related to sarcopenia in cirrhotic patients. However, the relationship between the GNRI and the prognosis in patients with liver cirrhosis (LC) has not been reported. The aim of the present research is to study the association of the GNRI with the nutritional status, hepatic function reserve, and prognosis in patients with liver cirrhosis (LC). Materials and Methods: A total of 370 cirrhotic patients whose nutritional statuses were evaluated using anthropometric measurements and bioimpedance analysis were studied. The associations between the GNRI and nutritional status and the GNRI and hepatic function reserve were analyzed. We also investigated the GNRI and prognosis of patients with LC. Results: The median age of the enrolled patients was 66 years old, and 266 (71.9%) patients had viral hepatitis-related LC. The GNRI was shown to decrease with the progression of chronic liver disease, represented by an increased FIB-4 index and severe Child–Pugh and mALBI grades. In addition, a low GNRI (<92) was associated with severe cirrhosis-related metabolic disorders, including a low branched-chain amino acid-to-tyrosine ratio (BTR) and a low zinc value. The GNRI was positively correlated with two nutrition-related anthropometric variables (% arm circumference and % arm muscle circumference), and a low GNRI was related to a low skeletal muscle mass index (SMI) (<7.0 kg/m2 for men or <5.7 kg/m2 for women), as determined by using bioimpedance analysis. In addition, patients with a low GNRI (<92) had a poorer prognosis than those with a high GNRI (≥92) (log-rank test: p = 0.0161, and generalized Wilcoxon test, p = 0.01261). Conclusions: Our results suggest that a low GNRI is related to severe chronic liver disease, low muscle volume, and a poor prognosis of patients with cirrhosis. Full article
(This article belongs to the Special Issue Viral Hepatitis Research: Updates and Challenges)
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13 pages, 522 KiB  
Article
Muscle Cramps in Outpatients with Liver Diseases in Tokyo, Japan
by Tatsuo Kanda, Reina Sasaki-Tanaka, Naoki Matsumoto, Shuhei Arima, Shini Kanezawa, Masayuki Honda, Mai Totsuka, Tomotaka Ishii, Ryota Masuzaki, Masahiro Ogawa, Hiroaki Yamagami and Hirofumi Kogure
Medicina 2023, 59(9), 1506; https://doi.org/10.3390/medicina59091506 - 22 Aug 2023
Cited by 1 | Viewed by 3611
Abstract
Background and Objectives: Muscle cramps are often observed in patients with liver diseases, especially advanced liver fibrosis. The exact prevalence of muscle cramps in outpatients with liver diseases in Japan is unknown. Patients and Methods: This study examined the prevalence of, and therapies [...] Read more.
Background and Objectives: Muscle cramps are often observed in patients with liver diseases, especially advanced liver fibrosis. The exact prevalence of muscle cramps in outpatients with liver diseases in Japan is unknown. Patients and Methods: This study examined the prevalence of, and therapies for, muscle cramps in outpatients with liver diseases in Tokyo, Japan. A total of 238 outpatients with liver diseases were retrospectively examined. We investigated whether they had muscle cramps using a visual analog scale (VAS) (from 0, none, to 10, strongest), and also investigated their therapies. Results: Muscle cramps were observed in 34 outpatients with liver diseases (14.3%); their mean VAS score was 5.53. A multivariate analysis demonstrated that older age (equal to or older than 66 years) was the only significant factor as-sociated with muscle cramps. The prevalence of muscle cramps among patients with liver diseases seemed not to be higher. The problem was that only 11 (32.4%) of 34 outpatients received therapy for their muscle cramps. Conclusions: Only age is related to muscle cramps, which is rather weak, and it is possible that this common symptom may not be limited to liver disease patients. Full article
(This article belongs to the Special Issue Viral Hepatitis Research: Updates and Challenges)
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13 pages, 1306 KiB  
Article
Expression of CYP2B6 Enzyme in Human Liver Tissue of HIV and HCV Patients
by Bozana Obradovic, Owain Roberts, Andrew Owen, Ivana Milosevic, Natasa Milic, Jovan Ranin and Gordana Dragovic
Medicina 2023, 59(7), 1207; https://doi.org/10.3390/medicina59071207 - 27 Jun 2023
Cited by 2 | Viewed by 1749
Abstract
Background and Objectives: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections present significant public health challenges worldwide. The management of these infections is complicated by the need for antiviral and antiretroviral therapies, which are influenced by drug metabolism mediated by [...] Read more.
Background and Objectives: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections present significant public health challenges worldwide. The management of these infections is complicated by the need for antiviral and antiretroviral therapies, which are influenced by drug metabolism mediated by metabolic enzymes and transporters. This study focuses on the gene expression of CYP2B6, CYP3A4, and ABCB1 transporters in patients with HIV, HCV, and HIV/HCV co-infection, aiming to assess their potential association with the choice of therapy, patohistological and clinical parameters of liver damage such as the stage of liver fibrosis, serum levels of ALT and AST, as well as the grade of liver inflammation and other available biochemical parameters. Materials and Methods: The study included 54 patients who underwent liver biopsy, divided into HIV-infected, HCV-infected, and co-infected groups. The mRNA levels of CYP2B6, CYP3A4, and ABCB1 was quantified and compared between the groups, along with the analysis of liver fibrosis and inflammation levels. Results: The results indicated a significant increase in CYP2B6 mRNA levels in co-infected patients, a significant association with the presence of HIV infection with an increase in CYP3A4 mRNA levels. A trend towards downregulation of ABCB1 expression was observed in patients using lamivudine. Conclusions: This study provides insight into gene expression of CYP2B6 CYP3A4, and ABCB1 in HIV, HCV, and HIV/HCV co-infected patients. The absence of correlation with liver damage, inflammation, and specific treatment interventions emphasises the need for additional research to elucidate the complex interplay between gene expression, viral co-infection, liver pathology, and therapeutic responses in these particular patients population. Full article
(This article belongs to the Special Issue Viral Hepatitis Research: Updates and Challenges)
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16 pages, 4583 KiB  
Article
Impact of Direct-Acting Antiviral Therapy on Liver Fibrosis Regression among People with Chronic HCV Infection: Results from a Real-Life Cohort in Patients Who Achieved Sustained Virological Response
by Alejandro García-Ros, Senador Morán, Virginia Núñez, Gonzalo García-Ros, Guadalupe Ruiz and José García-Solano
Medicina 2023, 59(4), 814; https://doi.org/10.3390/medicina59040814 - 21 Apr 2023
Cited by 5 | Viewed by 2389
Abstract
Background and Objectives: The global prevalence of chronic hepatitis C virus (HCV) infection is 0.8%, affecting around 58 million people worldwide. Treatment with DAAs reduces all-cause HCV mortality by 49–68%. This work aims to determine whether there is liver fibrosis regression (LFR) [...] Read more.
Background and Objectives: The global prevalence of chronic hepatitis C virus (HCV) infection is 0.8%, affecting around 58 million people worldwide. Treatment with DAAs reduces all-cause HCV mortality by 49–68%. This work aims to determine whether there is liver fibrosis regression (LFR) in patients who achieved Sustained Virological Response (SVR) after treatment with DAAs. Materials and Methods: An analytical, observational, single-center, and cohort study was carried out. The final sample consisted of 248 HCV-infected patients. All started treatment with DAAs between January 2015 and December 2017. Five measurements were performed to determine the fibrotic stage in patients (measured in kilopascals (kPa)) using transient elastography (FibroScan®, Echosens, The Netherlands). Results: Taking the baseline fibrotic stage as a reference, the distribution in subgroups was as follows: 77 F4 patients (31.0%); 55 F3 patients (22.2%); 53 F2 patients (21.4%); and 63 F0/F1 patients (25.4%). There were 40 patients (16.1%) with at least one HCV complication and 13 (5.2%) who developed hepatocellular carcinoma. The overall LFR rate was 77.8% (144 of 185 F2/F3/F4 patients, p = 0.01) at the end of the follow-up period. The highest mean FibroScan® values were observed in patients with: “male gender”; “metabolic syndrome”; “subtype 1a”; “NRP DAA”; “at least one HCV complication”; “death from HCV complications”; and “liver transplantation requirement”. Conclusions: Treatment with DAAs achieved high rates of LFR and a decrease in mean FibroScan® values in all subgroups. Full article
(This article belongs to the Special Issue Viral Hepatitis Research: Updates and Challenges)
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Review

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20 pages, 1766 KiB  
Review
Hepatitis E Virus: What More Do We Need to Know?
by Endrit Shahini, Antonella Argentiero, Alessandro Andriano, Francesco Losito, Marcello Maida, Antonio Facciorusso, Raffaele Cozzolongo and Erica Villa
Medicina 2024, 60(6), 998; https://doi.org/10.3390/medicina60060998 - 18 Jun 2024
Cited by 2 | Viewed by 2244
Abstract
Hepatitis E virus (HEV) infection is typically a self-limiting, acute illness that spreads through the gastrointestinal tract but replicates in the liver. However, chronic infections are possible in immunocompromised individuals. The HEV virion has two shapes: exosome-like membrane-associated quasi-enveloped virions (eHEV) found in [...] Read more.
Hepatitis E virus (HEV) infection is typically a self-limiting, acute illness that spreads through the gastrointestinal tract but replicates in the liver. However, chronic infections are possible in immunocompromised individuals. The HEV virion has two shapes: exosome-like membrane-associated quasi-enveloped virions (eHEV) found in circulating blood or in the supernatant of infected cell cultures and non-enveloped virions (“naked”) found in infected hosts’ feces and bile to mediate inter-host transmission. Although HEV is mainly spread via enteric routes, it is unclear how it penetrates the gut wall to reach the portal bloodstream. Both virion types are infectious, but they infect cells in different ways. To develop personalized treatment/prevention strategies and reduce HEV impact on public health, it is necessary to decipher the entry mechanism for both virion types using robust cell culture and animal models. The contemporary knowledge of the cell entry mechanism for these two HEV virions as possible therapeutic target candidates is summarized in this narrative review. Full article
(This article belongs to the Special Issue Viral Hepatitis Research: Updates and Challenges)
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23 pages, 773 KiB  
Review
Non-Invasive Diagnostic Tests for Portal Hypertension in Patients with HBV- and HCV-Related Cirrhosis: A Comprehensive Review
by Ciro Celsa, Marzia Veneziano, Francesca Maria Di Giorgio, Simona Cannova, Antonino Lombardo, Emanuele Errigo, Giuseppe Landro, Fabio Simone, Emanuele Sinagra and Vincenza Calvaruso
Medicina 2024, 60(5), 690; https://doi.org/10.3390/medicina60050690 - 24 Apr 2024
Viewed by 2020
Abstract
Clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease indicates an increased risk of decompensation and death. While invasive methods like hepatic venous–portal gradient measurement is considered the gold standard, non-invasive tests (NITs) have emerged as valuable tools for [...] Read more.
Clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease indicates an increased risk of decompensation and death. While invasive methods like hepatic venous–portal gradient measurement is considered the gold standard, non-invasive tests (NITs) have emerged as valuable tools for diagnosing and monitoring CSPH. This review comprehensively explores non-invasive diagnostic modalities for portal hypertension, focusing on NITs in the setting of hepatitis B and hepatitis C virus-related cirrhosis. Biochemical-based NITs can be represented by single serum biomarkers (e.g., platelet count) or by composite scores that combine different serum biomarkers with each other or with demographic characteristics (e.g., FIB-4). On the other hand, liver stiffness measurement and spleen stiffness measurement can be assessed using a variety of elastography techniques, and they can be used alone, in combination with, or as a second step after biochemical-based NITs. The incorporation of liver and spleen stiffness measurements, alone or combined with platelet count, into established and validated criteria, such as Baveno VI or Baveno VII criteria, provides useful tools for the prediction of CSPH and for ruling out high-risk varices, potentially avoiding invasive tests like upper endoscopy. Moreover, they have also been shown to be able to predict liver-related events (e.g., the occurrence of hepatic decompensation). When transient elastography is not available or not feasible, biochemical-based NITs (e.g., RESIST criteria, that are based on the combination of platelet count and albumin levels) are valid alternatives for predicting high-risk varices both in patients with untreated viral aetiology and after sustained virological response. Ongoing research should explore novel biomarkers and novel elastography techniques, but current evidence supports the utility of routine blood tests, LSM, and SSM as effective surrogates in diagnosing and staging portal hypertension and predicting patient outcomes. Full article
(This article belongs to the Special Issue Viral Hepatitis Research: Updates and Challenges)
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