Hepatitis | Links Medicus Content Curation & Alerts in Medicine

RCT | Bictegravir regimen noninferior to dolutegravir regimen in HIV-1, HBV co-infection treatment

31 Jul, 2023 | 14:00h | UTC

Bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir, emtricitabine, and tenofovir disoproxil fumarate for initial treatment of HIV-1 and hepatitis B coinfection (ALLIANCE): a double-blind, multicentre, randomised controlled, phase 3 non-inferiority trial – The Lancet HIV (free registration required)

RCT | Bulevirtide reduces HDV RNA and ALT levels in chronic hepatitis D patients

28 Jun, 2023 | 13:20h | UTC

Summary: This randomized phase 3 trial evaluated the efficacy of bulevirtide, an inhibitor of HDV entry into hepatocytes, in patients with chronic hepatitis D. Patients were randomized to receive either 2 mg or 10 mg of bulevirtide daily for 144 weeks, or no treatment for 48 weeks followed by 10 mg bulevirtide daily for 96 weeks. The study involved 150 patients, 49 in the 2-mg group, 50 in the 10-mg group, and 51 in the control group.

After 48 weeks of treatment, 45% and 48% of patients in the 2-mg and 10-mg groups respectively achieved the primary end point of undetectable HDV RNA level or a decrease of at least 2 log10 IU per milliliter from baseline, and normalization of ALT level. Only 2% in the control group reached the primary endpoint. ALT levels normalized in 51% and 56% of patients in the 2-mg and 10-mg groups respectively, a significant difference from the 12% normalization in the control group. Notably, loss of HBsAg did not occur by week 48 in the bulevirtide groups. No serious adverse events related to the treatment were reported, though side effects including headache, pruritus, and fatigue were more common in the bulevirtide groups.

These results demonstrate the effectiveness of bulevirtide in reducing HDV RNA and ALT levels in patients with chronic hepatitis D. However, the absence of HBsAg loss in bulevirtide groups raises questions about its long-term implications.

Article: A Phase 3, Randomized Trial of Bulevirtide in Chronic Hepatitis D – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary on Twitter

Presented today at #EASLCongress: In a randomized trial, 48 weeks of treatment with bulevirtide, which inhibits hepatitis D virus entry into hepatocytes, reduced HDV RNA and alanine aminotransferase levels in patients with chronic hepatitis D. https://t.co/Q8RNZFbQlQ

— NEJM (@NEJM) June 22, 2023

AASLD-IDSA Guideline | Updated 2023 recommendations for the testing, management, and treatment of Hepatitis C virus infection

1 Jun, 2023 | 12:21h | UTC

Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection – Clinical Infectious Diseases

Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU

17 Apr, 2023 | 13:19h | UTC

Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations – Critical Care Medicine (free for a limited period)

Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations – Critical Care Medicine (free for a limited period)

Cohort Study | Barriers to starting direct-acting antiviral treatment despite access for HIV & hepatitis C patients

6 Apr, 2023 | 13:09h | UTC

Reasons for not commencing direct-acting antiviral treatment despite unrestricted access for individuals with HIV and hepatitis C virus: a multinational, prospective cohort study – The Lancet Public Health

Invited Commentary: The road to hepatitis C virus elimination – The Lancet Public Health

CDC recommends HBV screening at least once in a lifetime for all adults aged ≥18 years

13 Mar, 2023 | 15:14h | UTC

Summary: The Centers for Disease Control and Prevention (CDC) has issued new recommendations for screening and testing for hepatitis B virus (HBV) infection in the US.

The recommendations include screening for HBV infection at least once in a lifetime for adults aged ≥18 years and more frequent testing for persons at increased risk for HBV infection. The risk groups include:

Persons incarcerated or formerly incarcerated in jail, prison, or other detention settings.
Persons with a history of sexually transmitted infections or multiple sex partners.
Persons with a history of hepatitis C virus infection.

The CDC recommends using the triple panel (HBsAg, anti-HBs, and total anti-HBc) for initial screening to help identify persons who have an active HBV infection, have resolved infection and might be susceptible to reactivation, are susceptible and need vaccination, or are vaccinated.

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