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Host–pathogen interactions in chronic HBV infection and transplantation of HCV-positive organs

HBV and HCV infections continue to be major global health problems, causing over 1 million deaths annually. Key studies this year investigated the innate and adaptive immune responses in different clinical scenarios in HBV infection, whereas others evaluated the merits of transplanting HCV-infected organs into uninfected recipients.

Key advances

  • HBV is able to act as a ‘stealth virus’ and evade the innate immune response1,2,3.

  • Factors associated with hepatitis flares after stopping antiviral therapy could eventually serve as biomarkers to predict who can safely stop treatment5,6.

  • Transmission of HCV can occur through liver transplantation despite absence of measurable viraemia in HCV-antibody positive donors, highlighting the need for close follow-up of patients receiving these organs7.

  • Organ transplantation from HCV-infected donors to HCV-uninfected recipients is safe but early and possibly even pre-emptive treatment is important to reduce the risk of relapse or severe initial infection8,9.

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Fig. 1: HBV and innate immune sensors.


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Correspondence to Jordan J. Feld.

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Competing interests

J.J.F. has received research support from Abbvie, Gilead, Janssen and Merck and honoraria for scientific consulting from Contravir, Enanta and Roche. A.J.G. has acted as a consultant for Aicuris, Arbutus, Roche and SpringBank Pharmaceuticals and has received research funding from Janssen & Gilead.

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Feld, J.J., Gehring, A.J. Host–pathogen interactions in chronic HBV infection and transplantation of HCV-positive organs. Nat Rev Gastroenterol Hepatol 16, 77–78 (2019).

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