Series |

Eliminating viral hepatitis

Viral hepatitis is a global public health problem, and the burden of disease is increasing. In 2016, spurred by development of effective new treatments for hepatitis C and expanding access to hepatitis B vaccination, the 194 Member States of the WHO committed to eliminating viral hepatitis as a public health threat by 2030. Here, Nature Reviews Gastroenterology & Hepatology explores areas vital to meeting this ambitious target, from basic viral research to public policy.

Reviews and Perspectives

The management of viral hepatitis in the setting of pregnancy requires special consideration. This Review examines each hepatitis virus individually to address the effect of pregnancy on the natural history of infection and how the viral infections influence maternal and infant outcomes, including mother-to-child transmission.

Review Article | | Nature Reviews Gastroenterology & Hepatology

Direct-acting antiviral agents (DAAs) have revolutionized the management of chronic hepatitis C, but their use in acute infection is unclear. This Review outlines the epidemiology, diagnosis and management of acute HCV infection, providing insights into the use of DAAs in at-risk populations (such as people who inject drugs).

Review Article | | Nature Reviews Gastroenterology & Hepatology

Direct-acting antiviral agents (DAAs) are highly effective treatments for HCV, but are not always accessible to people who inject drugs (PWID). Here, Grebely and colleagues outline the epidemiology of HCV in PWID, discuss current data on DAA outcomes in this population and highlight steps required to broaden access to HCV therapy with the eventual goal of HCV elimination.

Review Article | | Nature Reviews Gastroenterology & Hepatology

Comments and opinions

New national hepatitis C virus (HCV) screening guidance from the United States Preventive Services Task Force includes a recommendation for one-time testing for all adults aged 18 to 79 years. Implicit in the new guidance is that all people diagnosed with chronic HCV infection should be offered HCV treatment.

News & Views | | Nature Reviews Gastroenterology & Hepatology

Late presentation to hepatitis B virus and hepatitis C virus care is common, hindering global efforts to reduce the morbidity and mortality associated with liver disease. Models of care promoting and simplifying early testing of viral hepatitis are needed if we are to eliminate viral hepatitis as a major public health threat by 2030.

Comment | | Nature Reviews Gastroenterology & Hepatology

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.

Year in Review | | Nature Reviews Gastroenterology & Hepatology

More than 250 million people worldwide are chronically infected with the hepatitis B virus (HBV). In this Comment, members of the International Coalition to Eliminate HBV appraise the current policy environment and the need for appropriate cure research and preparedness to complement the WHO global elimination strategy, the HBV vaccine and the well-tolerated but poorly accessed therapy.

Comment | | Nature Reviews Gastroenterology & Hepatology

Recurrence of hepatocellular carcinoma after resection or ablation with curative intent is common and not prevented by direct-acting antiviral agent (DAA) therapy for hepatitis C. Owing to multiple methodological inconsistencies, available studies fail to answer whether DAA therapy anticipated risk of severe tumour recurrence: a prospective randomized study might serve the purpose.

News & Views | | Nature Reviews Gastroenterology & Hepatology

More people die from viral hepatitis than from HIV, yet the public health response is lacking. The ACHIEVE Coalition urges governments in Europe and elsewhere to improve hepatitis B and hepatitis C monitoring so that a reliable evidence base will be available to guide the drive towards disease elimination.

Comment | | Nature Reviews Gastroenterology & Hepatology

In April 2015, in partnership with the US Centers for Disease Control and Prevention and Gilead Sciences, the country of Georgia launched the world's first national HCV elimination programme, aiming to reduce HCV prevalence by 90% by 2020. After 2 years of progress, how can the Georgia experience inform global approaches to eliminating HCV?

Comment | | Nature Reviews Gastroenterology & Hepatology

Poster

This Poster illustrates the current epidemiology, clinical management and novel treatment targets of hepatitis B, a disease responsible for a large global burden of liver cirrhosis and cancer.

Poster | | Nature Reviews Gastroenterology & Hepatology