Top

Current Hepatology Reports

Published in:

01-12-2021 | Hepatitis A | Hepatitis B (JK Lim, Section Editor)

Management of Hepatitis B in Persons Who Inject Drugs (PWID)

Authors: Shang-Chin Huang, Jia-Horng Kao

Published in: Current Hepatology Reports | Issue 4/2021

Abstract

Purpose of Review

Hepatitis B remains an infectious disease causing a significant number of morbidity and mortality worldwide. Notably, the management of hepatitis B in persons who inject drugs (PWID) is a crucial part for hepatitis B virus (HBV) elimination. This narrative review summarizes the updated strategies of screening, prevention, and treatment for this special clinical setting.

Recent Findings

A PWID are associated with impaired immune responses and substantial vulnerability to parenteral HBV transmission with multiple co-infections, poor adherence, and social stigma. Multi-disciplinary support with integration of core strategies and healthcare systems provides better efficacy of prevention and treatment of HBV infection.

Summary

A Periodic monitoring, treating co-existing risk factors, promoting harm reduction services, specialized protocol for HBV vaccination, and remodeling of values and practices are important for HBV elimination in PWID as well as the general population. Global and nationwide policies should be made and implemented to achieve above goals.

Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol. 2018;3(6):383–403. https://doi.org/10.1016/s2468-1253(18)30056-6.

Geneva: World Health Organization. Global Hepatitis Report 2017.

Llovet JM, Kelley RK, Villanueva A, Singal AG, Pikarsky E, Roayaie S, et al. Hepatocellular carcinoma Nat Rev Dis Primers. 2021;7(1):6. https://doi.org/10.1038/s41572-020-00240-3.CrossRefPubMed

Huang SC, Yang HC, Kao JH. Hepatitis B reactivation: diagnosis and management. Expert Rev Gastroenterol Hepatol. 2020;14(7):565–78. https://doi.org/10.1080/17474124.2020.1774364.CrossRefPubMed

Liao SH, Chen CL, Hsu CY, Chien KL, Kao JH, Chen PJ et al. Long-term effectiveness of population-wide multifaceted interventions for hepatocellular carcinoma in Taiwan. J Hepatol. 2021. https://doi.org/10.1016/j.jhep.2021.02.029.

Yang HC, Kao JH. Persistence of hepatitis B virus covalently closed circular DNA in hepatocytes: molecular mechanisms and clinical significance. Emerg Microbes Infect. 2014;3(9): e64. https://doi.org/10.1038/emi.2014.64.CrossRefPubMedPubMedCentral

World Health Organization. Global health sector strategy on viral hepatitis 2016-2021. Towards ending viral hepatitis. 2016. https://apps.who.int/iris/handle/10665/246177.

Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Health. 2017;5(12):e1192–207. https://doi.org/10.1016/s2214-109x(17)30375-3.CrossRefPubMedPubMedCentral

Kamarulzaman A, Reid SE, Schwitters A, Wiessing L, El-Bassel N, Dolan K, et al. Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisoners. Lancet. 2016;388(10049):1115–26. https://doi.org/10.1016/s0140-6736(16)30769-3.CrossRefPubMed

10.

Hwang LY, Ross MW, Zack C, Bull L, Rickman K, Holleman M. Prevalence of sexually transmitted infections and associated risk factors among populations of drug abusers. Clin Infect Dis. 2000;31(4):920–6. https://doi.org/10.1086/318131.CrossRefPubMed

11.

Noska AJ, Belperio PS, Loomis TP, O’Toole TP, Backus LI. Prevalence of human immunodeficiency virus, hepatitis C virus, and hepatitis B virus among homeless and nonhomeless United States veterans. Clin Infect Dis. 2017;65(2):252–8. https://doi.org/10.1093/cid/cix295.CrossRefPubMedPubMedCentral

12.

Weaver T, Metrebian N, Hellier J, Pilling S, Charles V, Little N, et al. Use of contingency management incentives to improve completion of hepatitis B vaccination in people undergoing treatment for heroin dependence: a cluster randomised trial. Lancet. 2014;384(9938):153–63. https://doi.org/10.1016/s0140-6736(14)60196-3.CrossRefPubMed

13.

World Health Organization. Guidance on prevention of viral hepatitis B and C among people who inject drugs. 2012.

14.

Edelman EJ, So-Armah K, Cheng DM, Doyle MF, Coleman SM, Bridden C, et al. Impact of illicit opioid use on T cell subsets among HIV-infected adults. PLoS ONE. 2017;12(5): e0176617. https://doi.org/10.1371/journal.pone.0176617.CrossRefPubMedPubMedCentral

15.

Riss GL, Chang DI, Wevers C, Westendorf AM, Buer J, Scherbaum N, et al. Opioid maintenance therapy restores CD4+ T cell function by normalizing CD4+CD25(high) regulatory T cell frequencies in heroin user. Brain Behav Immun. 2012;26(6):972–8. https://doi.org/10.1016/j.bbi.2012.05.008.CrossRefPubMed

16.

Feng Y, Shi J, Gao L, Yao T, Feng D, Luo D, et al. Immunogenicity and safety of high-dose hepatitis B vaccine among drug users: a randomized, open-labeled, blank-controlled trial. Hum Vaccin Immunother. 2017;13(6):1–7. https://doi.org/10.1080/21645515.2017.1283082.CrossRefPubMed

17.

• Biancarelli DL, Biello KB, Childs E, Drainoni M, Salhaney P, Edeza A, et al. Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug Alcohol Depend. 2019;198:80–6. https://doi.org/10.1016/j.drugalcdep.2019.01.037. (Important study pointing out the impact of stigma on the behavior of PWID in healthcare setting)CrossRefPubMedPubMedCentral

18.

Mathers BM, Degenhardt L, Bucello C, Lemon J, Wiessing L, Hickman M. Mortality among people who inject drugs: a systematic review and meta-analysis. Bull World Health Organ. 2013;91(2):102–23. https://doi.org/10.2471/blt.12.108282.CrossRefPubMedPubMedCentral

19.

Visconti AJ, Sell J, Greenblatt AD. Primary care for persons who inject drugs. Am Fam Physician. 2019;99(2):109–16.PubMed

20.

Pol S, Haour G, Fontaine H, Dorival C, Petrov-Sanchez V, Bourliere M, et al. The negative impact of HBV/HCV coinfection on cirrhosis and its consequences. Aliment Pharmacol Ther. 2017;46(11–12):1054–60. https://doi.org/10.1111/apt.14352.CrossRefPubMed

21.

Hu J, Liu K, Luo J. HIV-HBV and HIV-HCV coinfection and liver cancer development. Cancer Treat Res. 2019;177:231–50. https://doi.org/10.1007/978-3-030-03502-0_9.CrossRefPubMed

22.

Brookmeyer KA, Haderxhanaj LT, Hogben M, Leichliter J. Sexual risk behaviors and STDs among persons who inject drugs: a national study. Prev Med. 2019;126: 105779. https://doi.org/10.1016/j.ypmed.2019.105779.CrossRefPubMedPubMedCentral

23.

Reno H, Fox B, Highfill C, McKee A, Trolard A, Liang SY, et al. The emerging intersection between injection drug use and early syphilis in nonurban areas of Missouri, 2012–2018. J Infect Dis. 2020;222(Suppl 5):S465–70. https://doi.org/10.1093/infdis/jiaa056.CrossRefPubMed

24.

Yi S, Prem K, Chhoun P, Chann N, Tuot S, Mun P, et al. Syphilis infection among people who use and inject drugs in Cambodia: a cross-sectional study using the respondent-driven sampling method. Int J STD AIDS. 2020;31(9):832–40. https://doi.org/10.1177/0956462420929132.CrossRefPubMed

25.

Kahwati LC, Feltner C, Halpern M, Woodell CL, Boland E, Amick HR, et al. Primary care screening and treatment for latent tuberculosis infection in adults: evidence report and systematic review for the US preventive services task force. JAMA. 2016;316(9):970–83. https://doi.org/10.1001/jama.2016.10357.CrossRefPubMed

26.

Auguste P, Tsertsvadze A, Pink J, Court R, McCarthy N, Sutcliffe P, et al. Comparing interferon-gamma release assays with tuberculin skin test for identifying latent tuberculosis infection that progresses to active tuberculosis: systematic review and meta-analysis. BMC Infect Dis. 2017;17(1):200. https://doi.org/10.1186/s12879-017-2301-4.CrossRefPubMedPubMedCentral

27.

Gambiez C, Garet C, Choquet M, Decroix V, Pluquet E, Guiheneuf R, et al. Limited efficacy of nontreponemal test combined with treponemal test in the initial syphilis screening algorithm. J Med Microbiol. 2019;68(2):216–20. https://doi.org/10.1099/jmm.0.000886.CrossRefPubMed

28.

Tassopoulos NC, Papaevangelou GJ, Sjogren MH, Roumeliotou-Karayannis A, Gerin JL, Purcell RH. Natural history of acute hepatitis B surface antigen-positive hepatitis in Greek adults. Gastroenterology. 1987;92(6):1844–50. https://doi.org/10.1016/0016-5085(87)90614-7.CrossRefPubMed

29.

Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HL, Chen CJ, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2016;10(1):1–98. https://doi.org/10.1007/s12072-015-9675-4.CrossRefPubMed

30.

Goyal A, Ribeiro RM, Perelson AS. The role of infected cell proliferation in the clearance of acute HBV infection in humans. Viruses. 2017;9(11). https://doi.org/10.3390/v9110350.

31.

Yu WH, Cosgrove C, Berger CT, Cheney PC, Krykbaeva M, Kim AY, et al. ADCC-mediated CD56(DIM) NK cell responses are associated with early HBsAg clearance in acute HBV infection. Pathog Immun. 2018;3(1):2–18. https://doi.org/10.20411/pai.v3i1.228.CrossRefPubMedPubMedCentral

32.

Diasso PDK, Birke H, Nielsen SD, Main KM, Højsted J, Sjøgren P, et al. The effects of long-term opioid treatment on the immune system in chronic non-cancer pain patients: a systematic review. Eur J Pain. 2020;24(3):481–96. https://doi.org/10.1002/ejp.1506.CrossRefPubMed

33.

Smedile A, Farci P, Verme G, Caredda F, Cargnel A, Caporaso N, et al. Influence of delta infection on severity of hepatitis B. Lancet. 1982;2(8305):945–7. https://doi.org/10.1016/s0140-6736(82)90156-8.CrossRefPubMed

34.

European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370–98. https://doi.org/10.1016/j.jhep.2017.03.021.

35.

Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560–99. https://doi.org/10.1002/hep.29800.CrossRefPubMed

36.

Mravčík V, Strada L, Stolfa J, Bencko V, Groshkova T, Reimer J, et al. Factors associated with uptake, adherence, and efficacy of hepatitis C treatment in people who inject drugs: a literature review. Patient Prefer Adherence. 2013;7:1067–75. https://doi.org/10.2147/ppa.S49113.CrossRefPubMedPubMedCentral

37.

Read P, Gilliver R, Kearley J, Lothian R, Cunningham EB, Chronister KJ, et al. Treatment adherence and support for people who inject drugs taking direct-acting antiviral therapy for hepatitis C infection. J Viral Hepat. 2019;26(11):1301–10. https://doi.org/10.1111/jvh.13175.CrossRefPubMed

38.

Lan CW, Lin C, Thanh DC, Li L. Drug-related stigma and access to care among people who inject drugs in Vietnam. Drug Alcohol Rev. 2018;37(3):333–9. https://doi.org/10.1111/dar.12589.CrossRefPubMed

39.

Lackner C, Tiniakos D. Fibrosis and alcohol-related liver disease. J Hepatol. 2019;70(2):294–304. https://doi.org/10.1016/j.jhep.2018.12.003.CrossRefPubMed

40.

Irvin R, Chander G, Falade-Nwulia O, Astemborski J, Starbird L, Kirk GD, et al. Overlapping epidemics of alcohol and illicit drug use among HCV-infected persons who inject drugs. Addict Behav. 2019;96:56–61. https://doi.org/10.1016/j.addbeh.2019.04.023.CrossRefPubMedPubMedCentral

41.

Barré T, Marcellin F, Di Beo V, Delorme J, Rojas Rojas T, Mathurin P, et al. Untreated alcohol use disorder in people who inject drugs (PWID) in France: a major barrier to HCV treatment uptake (the ANRS-FANTASIO study). Addiction. 2020;115(3):573–82. https://doi.org/10.1111/add.14820.CrossRefPubMed

42.

Fairbairn N, Hayashi K, Milloy MJ, Nolan S, Nguyen P, Wood E, et al. Hazardous alcohol use associated with increased sexual risk behaviors among people who inject drugs. Alcohol Clin Exp Res. 2016;40(11):2394–400. https://doi.org/10.1111/acer.13216.CrossRefPubMedPubMedCentral

43.

Kanda T, Sasaki R, Masuzaki R, Takahashi H, Mizutani T, Matsumoto N et al. Co-occurrence of hepatitis A infection and chronic liver disease. Int J Mol Sci. 2020;21(17). https://doi.org/10.3390/ijms21176384.

44.

Medrzycki M, Kamili S, Purdy MA. Hepatitis A virus survival on drug paraphernalia. J Viral Hepat. 2020;27(12):1484–94. https://doi.org/10.1111/jvh.13379.CrossRefPubMed

45.

Collier MG, Drobeniuc J, Cuevas-Mota J, Garfein RS, Kamili S, Teshale EH. Hepatitis A and B among young persons who inject drugs–vaccination, past, and present infection. Vaccine. 2015;33(24):2808–12. https://doi.org/10.1016/j.vaccine.2015.04.019.CrossRefPubMed

46.

• Rashti R, Sharafi H, Alavian SM, Moradi Y, Mohamadi Bolbanabad A, Moradi G. Systematic review and meta-analysis of global prevalence of HBsAg and HIV and HCV antibodies among people who inject drugs and female sex workers. Pathogens. 2020;9(6). https://doi.org/10.3390/pathogens9060432. (Important review of current prevalence of viral hepatitis among PWID)

47.

Heffernan A, Cooke GS, Nayagam S, Thursz M, Hallett TB. Scaling up prevention and treatment towards the elimination of hepatitis C: a global mathematical model. Lancet. 2019;393(10178):1319–29. https://doi.org/10.1016/s0140-6736(18)32277-3.CrossRefPubMedPubMedCentral

48.

Valencia J, Alvaro-Meca A, Troya J, Cuevas G, Gutiérrez J, Morro A, et al. High rates of early HCV reinfection after DAA treatment in people with recent drug use attended at mobile harm reduction units. Int J Drug Policy. 2019;72:181–8. https://doi.org/10.1016/j.drugpo.2019.06.016.CrossRefPubMed

49.

Akiyama MJ, Lipsey D, Heo M, Agyemang L, Norton BL, Hidalgo J, et al. Low hepatitis C reinfection following direct-acting antiviral therapy among people who inject drugs on opioid agonist therapy. Clin Infect Dis. 2020;70(12):2695–702. https://doi.org/10.1093/cid/ciz693.CrossRefPubMed

50.

Kanda T, Lau GKK, Wei L, Moriyama M, Yu ML, Chuang WL, et al. APASL HCV guidelines of virus-eradicated patients by DAA on how to monitor HCC occurrence and HBV reactivation. Hepatol Int. 2019;13(6):649–61. https://doi.org/10.1007/s12072-019-09988-7.CrossRefPubMed

51.

Haussig JM, Nielsen S, Gassowski M, Bremer V, Marcus U, Wenz B, et al. A large proportion of people who inject drugs are susceptible to hepatitis B: results from a bio-behavioural study in eight German cities. Int J Infect Dis. 2018;66:5–13. https://doi.org/10.1016/j.ijid.2017.10.008.CrossRefPubMed

52.

Njoroge J, Hope VD, O’Halloran C, Edmundson C, Glass R, Parry JV, et al. Are there missed opportunities for vaccinating against hepatitis B among people who inject drugs in the UK? Epidemiol Infect. 2019;147: e244. https://doi.org/10.1017/s0950268819001353.CrossRefPubMedPubMedCentral

53.

Palmateer NE, Goldberg DJ, Munro A, Taylor A, Yeung A, Wallace LA, et al. Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs. Addiction. 2018;113(1):80–90. https://doi.org/10.1111/add.13944.CrossRefPubMed

54.

Hwang LY, Grimes CZ, Tran TQ, Clark A, Xia R, Lai D, et al. Accelerated hepatitis B vaccination schedule among drug users: a randomized controlled trial. J Infect Dis. 2010;202(10):1500–9. https://doi.org/10.1086/656776.CrossRefPubMed

55.

Shah DP, Grimes CZ, Nguyen AT, Lai D, Hwang LY. Long-term effectiveness of accelerated hepatitis B vaccination schedule in drug users. Am J Public Health. 2015;105(6):e36-43. https://doi.org/10.2105/ajph.2014.302487.CrossRefPubMedPubMedCentral

56.

Lee GH, Lim SG. CpG-adjuvanted hepatitis B vaccine (HEPLISAV-B®) update. Expert Rev Vaccines. 2021:1–9. https://doi.org/10.1080/14760584.2021.1908133.

57.

• Rosenthal EM, Hall EW, Rosenberg ES, Harris A, Nelson NP, Schillie S. Assessing the cost-utility of preferentially administering Heplisav-B vaccine to certain populations. Vaccine. 2020;38(51):8206–15. https://doi.org/10.1016/j.vaccine.2020.10.067. (Novel cost-utility analysis demonstrating the superiority of the new HBV vaccine for PWID)CrossRefPubMed

58.

•• van Santen DK, Anders B, Matser A, Maher L, Hickman M, Lodi S, et al. The effect of needle and syringe program and opioid agonist therapy on the risk of HIV, hepatitis B and C virus infection for people who inject drugs in Amsterdam, the Netherlands: findings from an emulated target trial. Addiction. 2021. https://doi.org/10.1111/add.15503. (Important study regarding the effect of harm reduction services on hepatitis B prevention in PWID)CrossRefPubMed

59.

AlankoBlomé M, Björkman P, Flamholc L, Jacobsson H, Widell A. Vaccination against hepatitis B virus among people who inject drugs - a 20year experience from a Swedish needle exchange program. Vaccine. 2017;35(1):84–90. https://doi.org/10.1016/j.vaccine.2016.11.041.CrossRef

60.

Hancock E, Ward Z, Ayres R, Neale J, Hussey D, Kesten JM, et al. Detachable low dead space syringes for the prevention of hepatitis C among people who inject drugs in Bristol, UK: an economic evaluation. Addiction. 2020;115(4):702–13. https://doi.org/10.1111/add.14849.CrossRefPubMed

61.

Baker P, Beletsky L, Avalos L, Venegas C, Rivera C, Strathdee SA, et al. Policing practices and risk of HIV infection among people who inject drugs. Epidemiol Rev. 2020;42(1):27–40. https://doi.org/10.1093/epirev/mxaa010.CrossRefPubMedPubMedCentral

62.

Smith JM, Uvin AZ, Macmadu A, Rich JD. Epidemiology and treatment of hepatitis B in prisoners. Curr Hepatol Rep. 2017;16(3):178–83. https://doi.org/10.1007/s11901-017-0364-8.CrossRefPubMedPubMedCentral

63.

Csete J, Kamarulzaman A, Kazatchkine M, Altice F, Balicki M, Buxton J, et al. Public health and international drug policy. Lancet. 2016;387(10026):1427–80. https://doi.org/10.1016/s0140-6736(16)00619-x.CrossRefPubMedPubMedCentral

64.

Werb D, Rowell G, Guyatt G, Kerr T, Montaner J, Wood E. Effect of drug law enforcement on drug market violence: a systematic review. Int J Drug Policy. 2011;22(2):87–94. https://doi.org/10.1016/j.drugpo.2011.02.002.CrossRefPubMed

65.

Schleifer R, Pol L. International guidelines on human rights and drug control: a tool for securing women’s rights in drug control policy. Health Hum Rights. 2017;19(1):253–61.PubMedPubMedCentral

Title: Management of Hepatitis B in Persons Who Inject Drugs (PWID)
Authors: Shang-Chin Huang
Jia-Horng Kao
Publication date: 01-12-2021
Publisher: Springer US
Keywords: Hepatitis A
Hepatitis B
Vaccination
Human Immunodeficiency Virus
Hepatitis C
Published in: Current Hepatology Reports / Issue 4/2021
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-021-00574-w

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 4/2021

HCV and Liver Transplantation

Care After Cure: Long-term Follow-up in Hepatitis C

Sexual Dimorphisms in Nonalcoholic Fatty Liver Disease

Diagnostic Testing for SARS-CoV-2 Infection

Real-World Safety and Effectiveness of Oral Nucleos(t)ide Analogs in the Treatment of Chronic Hepatitis B Virus Infection

Burden, Quality of Life, and Palliative Care for Family Caregivers of Individuals with Advanced Liver Disease: a Systematic Literature Review

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage