The epidemiological changes of HCV and HBV infections in the era of new antiviral therapies and the anti-HBV vaccine

Abstract

The World Health Organization (WHO) resolution adopted in 2010 recognized viral hepatitis as a global health problem. In April 2014, for the first time, the WHO produced guidelines for the screening, care and treatment of persons with hepatitis C infections. In May 2014, a follow-up resolution urged WHO Member States to develop and implement a national strategy for the prevention, diagnosis and treatment of viral hepatitis based on the local epidemiological context. Although blood donor screening, which began in the early 1990s, has reduced the spread of the virus in the population, the WHO estimates that 150 million people are chronically infected with hepatitis C virus (HCV) and are at an increased risk of developing liver cirrhosis and hepatocellular carcinoma. In addition, 3-4 million people are infected each year. HCV treatment is currently evolving rapidly, and several drugs are in various stages of development. With regard to the hepatitis B virus (HBV), in March 2015, the WHO published the first guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection, which were designed to complement the recent guidelines on HCV. Although the introduction of an effective vaccine against the hepatitis B virus has reduced the prevalence and health and economic impact of hepatitis in industrialized countries, the WHO estimates that more than 2 billion people are HBV-infected and 350 million people are chronic carriers.

Attempt to calculate the prevalence and features of chronic hepatitis C infection in Tuscany using administrative data

“…However, interferon- and ribavirin-treatment free regimens are available and require shorter treatment periods (3 mo). These regimens do not have substantial side effects and are also effective in patients with decompensated cirrhosis[16]. …”

Hepatitis C-related hepatocellular carcinoma in the era of new generation antivirals

“…In addition, the high frequency of unrecognized HCV infection in the general and specific (e.g., inmates and homeless) populations, estimated at 50% or above of infected individuals, hampers control of the virus even with the commercialization of DAAs [5, 6]. With the 3–4 million newly infected cases each year, it is estimated that the HCV-associated disease burden will remain high in the next decade, even in developed countries [7–9]. …”

Identification of anti-HBV activities in Paeonia suffruticosa Andr. using GRP78 as a drug target on Herbochip®

“…There are more than 4 million clinical cases of acute HBV infection every year. In low-endemic countries, such as North America and Northern Europe, the estimated prevalence of HBV surface antigen (HBsAg)-positive subjects is less than 2%, while that of high-endemic countries, such as sub-Saharan Africa and China, is greater than 8% [1, 2]. Globally, WHO estimates that approximately 240 million people are chronically infected with hepatitis B (defined as HBsAg-positive for longer than 6 months), and 780 thousand persons die each year for HBV infection—650 thousand from cirrhosis and hepatocellular carcinoma (HCC) due to chronic infection and another 130 thousand from acute hepatitis B [1].…”

“…Currently, peginterferon and nucleos(t)ide analogues (NUCs) are common frontline antiviral agents against HBV [2, 8, 9]. However, significant side-effect profile of interferon and drug resistance in NUCs both limits its long-term use and drug resistance in NUCs could limit long-term monotherapy.…”