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Daily Medical Update
Hepatitis B & C (Screening, direct-acting antivirals)
Friday, March 20, 2026
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🔬 Practice‑Changing Findings
Evidence from RCTs and meta‑analyses published in the last 12 months.
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Open Forum Infectious Diseases (2025) - Cohort Study
Key Findings
- In 2021-2023, 75% of 6,637,294 veterans aged 18-79 in care had HCV testing completed.
- Among antibody-positive patients, 95.5% received confirmatory testing, improving completion of the diagnostic cascade.
📋 Practice Implication: Embed universal adult HCV screening with reflex confirmatory pathways in primary care systems to reduce drop-off between initial and definitive diagnosis.
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European Journal of Public Health (2025) - Population Screening Study
Key Findings
- Nationwide screening of 1,048,575 people found HBsAg prevalence of 2.89% and anti-HCV prevalence of 3.52%.
- DAA outcomes improved viral control, with virologic non-clearance reduced to under 1.2% in both advanced-fibrosis and non-advanced-fibrosis groups.
📋 Practice Implication: Pair mass screening programs with immediate treatment linkage because high-throughput case finding can still produce excellent real-world cure rates when therapy access is organized.
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Frontiers in Immunology (2025) - Systematic Review
Key Findings
- Across 26 included studies (n=919), DAA cure improved but did not fully normalize exhausted T-cell function.
- Advanced fibrosis was associated with increased persistence of post-cure immune exhaustion.
📋 Practice Implication: After SVR, prioritize longer-term monitoring intensity in patients with advanced fibrosis because virologic cure alone may not normalize downstream immune-driven risk.
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Journal of Hepatology (2025) - Multinational Registry/Sales Analysis
Key Findings
- From 2014-2023, an estimated 13.8 million people were treated for HCV, representing 21% of all infections in assessed regions.
- In high-income settings, treatment volume reduced by 41% from peak, showing stagnation after early program gains.
📋 Practice Implication: Shift elimination strategy from passive treatment availability to proactive case-finding in underdiagnosed populations to prevent stagnation in treatment uptake.
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Lancet Haematology (2025) - Practice Guideline
Key Findings
- Updated consensus recommendations improved standardization of HBV/HCV/HEV screening, prevention, treatment, and surveillance in hematology and transplant settings.
- Proactive viral-hepatitis management reduced risk of cancer-therapy delay or modification from infection-related complications.
📋 Practice Implication: For patients entering immunosuppressive oncology pathways, standardize pre-treatment hepatitis panels and rapid specialist co-management to avoid preventable treatment delays.
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Journal of Viral Hepatitis (2025) - Prospective Program Evaluation
Key Findings
- Among 508 valid HCV tests in custody suites, 6% had active HCV RNA infection and 39% of RNA-positive cases were newly identified.
- After diagnosis, 77% of RNA-positive individuals initiated antiviral treatment, improving linkage-to-care in this high-risk setting.
📋 Practice Implication: Add opt-out HCV testing in correctional and custody-linked care pathways to capture high-prevalence cases and convert diagnosis into treatment initiation at the point of contact.
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Recent real-world and policy data show that broad hepatitis C screening plus reliable confirmatory testing can be implemented at scale, while DAA therapy continues to deliver high cure rates across diverse settings. At the same time, post-cure risk is not uniform: advanced fibrosis and added host-risk markers still justify structured surveillance. For primary care, the biggest gains now come from closing diagnosis and linkage gaps in high-risk and underserved populations.
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