Hepatitis Awareness Month: acute hepatitis in children, WHO guidance and more

May is Hepatitis Awareness Month, and the CDC and its public health partners are raising awareness and encouraging increased screening and vaccination.

According to the Coalition for Global Hepatitis Elimination, approximately 325 million people worldwide were affected by hepatitis in 2018. Despite the availability of vaccines, more than 80% of people with hepatitis lack access to testing and treatment.

In support of Hepatitis Awareness Month, Healio has compiled seven recent reports on the acute hepatitis outbreak in children, the importance of screening, emerging drug therapies, WHO elimination targets and more.

VIDEO: Although acute hepatitis in children uncommon, parents should remain vigilant

In this Healio video exclusive, Elizabeth Fagan, MD, an independent hepatologist and consultant in Texas, discusses global concerns about cases of acute, severe hepatitis in children and what caregivers should be aware of.

According to Fagan, there are now nearly 300 cases of severe hepatitis in children worldwide, as reported by the WHO and the CDC. Symptoms include nausea, vomiting, diarrhea and general malaise, as well as progression to jaundice of the eyes and skin, dark urine and pale stools. Some children may experience respiratory problems. Read more.

CDC: Investigation ongoing for acute hepatitis in children

The CDC reported during a media telebriefing that it is investigating cases of acute hepatitis of unknown etiology among children in the United States but warns it will take time to evaluate evidence.

The agency’s investigation currently includes 109 cases of acute hepatitis in children in 25 states and territories over the past 7 months. More than 90% of these patients were hospitalized and 14% received liver transplants; there have been five deaths. Cases have been reported in Alabama, Arizona, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Michigan, Minnesota, Missouri, Nebraska, New York, North Carolina, North Dakota, Ohio, Pennsylvania, Puerto Rico, Tennessee, Texas, Washington and Wisconsin. Read more.

VIDEO: Bulevirtide improves quality of life in chronic HDV

Bulevirtide improved quality of life measures among patients treated for chronic hepatitis D virus, Maria Buti, MD, PhD, of the Vall d'Hebron University Hospital in Spain, told Healio.

In a multicenter, phase 3 study, researchers evaluated the health-related quality of life benefits as measured by the Hepatitis Quality of Life Questionnaire (HQLQ) following 24 weeks of bulevirtide 2 mg or delayed treatment. From baseline to study conclusion, results yielded improvements in all domains of the HQLQ among patients treated with bulevirtide. Read more.

‘We should be screening now’ for HDV with emerging drug therapies in phase 3

Without approved treatment options for hepatitis D, screening has largely fallen by the wayside; however, promising therapies in phase 3 trials may shift that paradigm, according to a presenter at the GUILD Conference.

“Hepatitis D is a virus that I think we don’t talk very much about; in fact, the general sense among several of my colleagues is ‘I don’t even test for delta,’” Norah Terrault, MD, MPH, professor of medicine and chief of gastroenterology and liver at the Keck School of Medicine at USC, told attendees. “I’m trying to convince you otherwise. We should be screening for delta. It’s out there; you just have to look for it.” Read more.

Heavy alcohol use increases liver impairment, risk for HCC in hepatitis-induced cirrhosis

Among patients with hepatitis-induced cirrhosis, heavy alcohol consumption increased liver function impairment and hepatocellular carcinoma prevalence, according to research.

“Heavy alcohol consumption had been shown to accelerate the development of liver fibrosis and to increase the prevalence of HCC and mortality in HCV infected patients,” Kodjo-Kunale Abassa, of the department of gastroenterology at The Third Affiliated Hospital of Sun Yat-Sen University in China, and colleagues wrote. “Nevertheless, more needs to be explored about the prevalence of other liver cirrhosis complications such as esophageal and gastric variceal bleeding among these groups of patients.” Read more.

Increased HCV diagnosis, treatment necessary to hit WHO elimination targets

The prevalence of hepatitis C infections has declined globally, but countries must scale up rates of diagnosis and treatment to achieve the WHO targets to eliminate HCV by 2030, according to new data.

“Our objective for this project was to evaluate the global prevalence of HCV and establish a new baseline for future elimination efforts,” Sarah Blach, MHS, CPH, HCV group team lead and epidemiologist at the Center for Disease Analysis Foundation, said during a presentation at The Liver Meeting Digital Experience. Read more.

WHO releases global guidance for HBV, HCV elimination

WHO has released the first-ever global guidance for countries seeking validated hepatitis B virus and hepatitis C virus elimination.

“The 2016 WHO Global Health Sector Strategy (GHSS) on viral hepatitis provided a roadmap for the elimination of viral hepatitis as a public health problem by 2030,” Philippa Easterbrook, MD, of the global hepatitis and HIV department at WHO, and colleagues wrote. “The 2020 Sustainable Development Goals and GHSS target of reducing the incidence of hepatitis B has been met. However, most other global 2020 targets have been missed, and accelerated action is needed to reach elimination.” Read more.