Correctional facilities are a major hub of hepatitis C virus (HCV), with rates far higher than those observed in the general population. Once considered an intractable crisis, the current situation offers a unique opportunity. The advent of direct-acting antivirals has changed the HCV treatment landscape, making its elimination possible. This review summarises the scientific evidence and progress towards HCV elimination in correctional health systems. It outlines the evolution of 'test-and-treat' models, assesses micro-elimination success worldwide, especially in Singapore, and highlights collaborative efforts between Changi General Hospital and Singapore Prison Services. Their implementation of HCV treatment guidelines serves as a key case study in this context. This review also analyses the various barriers - structural, financial, clinical and logistical - that hinder progress. It consolidates strong evidence that prison-based HCV treatment is cost-effective, promotes health equity, supports the World Health Organization 2030 goals and reduces the societal burden of HCV.
Humans ; Singapore ; Antiviral Agents/therapeutic use* ; Hepatitis C, Chronic/epidemiology* ; Prisons ; Prisoners ; Disease Eradication ; Cost-Benefit Analysis ; Hepacivirus ; Correctional Facilities

Humans ; Dengue/epidemiology* ; Child ; Dengue Virus/isolation & purification* ; China/epidemiology* ; Consensus

Mosquito-borne viruses, including dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV), pose major threats to public health in tropical and subtropical regions worldwide. Neonates are particularly vulnerable, and the associated disease burden has drawn increasing attention. Routes of neonatal infection include vertical mother-to-child transmission (transplacental and peripartum) and postnatal mosquito bites. Clinical manifestations are often nonspecific; a proportion of cases may progress to central nervous system infection, hemorrhagic disease, or long-term neurodevelopmental impairment, with serious consequences for survival and quality of life. Although China has issued prevention and control guidelines for adults and pregnant women, systematic clinical guidance tailored to neonates remains lacking. In response, the Perinatal Group of the Pediatric Branch of the Chinese Medical Doctor Association convened a multidisciplinary panel to develop this expert consensus, integrating the latest international evidence with China's practical prevention and control experience. The consensus addresses epidemiology; the effects of maternal infection on fetuses and neonates; clinical manifestations; diagnosis and differential diagnosis; early warning indicators of severe disease; therapeutic strategies and supportive care; and prevention and maternal-infant management. It aims to provide evidence-based, standardized, and practical guidance for frontline clinicians managing neonatal mosquito-borne viral infections.
Humans ; Zika Virus Infection/therapy* ; Infant, Newborn ; Chikungunya Fever/therapy* ; Dengue/prevention & control* ; Female ; Pregnancy ; Consensus

OBJECTIVE: To investigate chronic hepatitis C virus (HCV) infection's effect on gestational liver function, pregnancy and delivery complications, and neonatal development. METHODS: A total of 157 HCV antibody-positive (anti-HCV[+]) and HCV RNA(+) patients (Group C) and 121 anti-HCV(+) and HCV RNA(-) patients (Group B) were included as study participants, while 142 anti-HCV(-) and HCV RNA(-) patients (Group A) were the control group. Data on biochemical indices during pregnancy, pregnancy complications, delivery-related information, and neonatal complications were also collected. RESULTS: Elevated alanine aminotransferase (ALT) rates in Group C during early, middle, and late pregnancy were 59.87%, 43.95%, and 42.04%, respectively-significantly higher than Groups B (26.45%, 15.70%, 10.74%) and A (23.94%, 19.01%, 6.34%) ( P < 0.05). Median ALT levels in Group C were significantly higher than in Groups A and B at all pregnancy stages ( P < 0.05). No significant differences were found in neonatal malformation rates across groups ( P > 0.05). However, neonatal jaundice incidence was significantly greater in Group C (75.16%) compared to Groups A (42.25%) and B (57.02%) ( χ ² = 33.552, P < 0.001). HCV RNA positivity during pregnancy was an independent risk factor for neonatal jaundice ( OR = 2.111, 95% CI 1.242-3.588, P = 0.006). CONCLUSIONS Chronic HCV infection can affect the liver function of pregnant women, but does not increase the pregnancy or delivery complication risks. HCV RNA(+) is an independent risk factor for neonatal jaundice.
Humans ; Female ; Pregnancy ; Adult ; Pregnancy Complications, Infectious/epidemiology* ; Retrospective Studies ; Pregnancy Outcome ; Infant, Newborn ; Viremia/virology* ; Hepatitis C ; Hepacivirus/physiology* ; Hepatitis C, Chronic/virology* ; Young Adult ; Alanine Transaminase/blood*

This study aims to establish a high-performance size-exclusion chromatography (HPSEC) method for determining the content of the classical swine fever virus (CSFV) E2 protein and screen the optimal stabilizer to enhance the stability of this protein. The optimal detection conditions were determined by optimizing the composition of the mobile phase, and characteristic chromatographic peaks were identified by SDS-PAGE and Western blotting. The specificity, repeatability, precision, linearity, limit of detection (LOD), and limit of quantitation (LOQ) of the method were assessed. The method established was used to determine the content of CSFV E2 protein antigen and vaccine. Differential scanning fluorimetry (DSF) was employed to screen the buffer system, pH, and salt ion concentrations, and sugar, amino acid, and alcohol stabilizers were further screened. The results showed that using a 200 mmol/L phosphate buffer provided the best column efficiency. An antigen-specific chromatographic peak appeared at the retention time of 18 min, which was identified as the CSFV E2 protein by SDS-PAGE and Western blotting. The method exhibited high specificity for detecting the CSFV E2 protein, with no absorbance peak observed in the blank control. The relative standard deviation (RSD) of the peak area for six repeated injections of the CSFV E2 protein was 0.74%, indicating good repeatability of the method. The RSD for repeated detection of two different concentrations of CSFV E2 protein samples by different operators at different time points was less than 2%, suggesting good intermediate precision of the method. The peak area of the CSFV E2 protein was linearly related to its concentration, with the regression equation showing R² of 1.000. The LOD and LOQ of the method were 14.88 μg/mL and 29.75 μg/mL, respectively. Application of the developed method in the detection of three batches of CSFV E2 protein antigen and three batches of vaccine demonstrated results consistent with those from the bicinchoninic acid (BCA) assay, which meant that the method could accurately determine the content of CSFV E2 protein antigen and vaccine. The DSF method identified 50 mmol/L Tris-HCl at pH 8.0 as the optimal buffer, and the addition of sugar and alcohol stabilizers further improved the stability of the CSFV E2 protein. The HPSEC method established in this study is simple, fast, and exhibits good accuracy and repeatability, enabling precise measurement of the CSFV E2 protein content. It is expected to play a crucial role in the quality control of the CSFV E2 vaccine. Furthermore, the strategy for improving the CSFV E2 protein stability, identified through DSF screening, has significant implications for enhancing the stability of the CSFV E2 vaccine.
Classical Swine Fever Virus/chemistry* ; Chromatography, Gel/methods* ; Animals ; Swine ; Viral Envelope Proteins/immunology*

Dengue fever is a mosquito-borne disease prevalent in tropical and subtropical regions, with its prevalence expanding due to increased global travel. The dengue virus, the causative agent of dengue fever, often co-circulates in the form of four distinct serotypes. Cross-reactive antibodies generated during a primary infection pose a significant risk during secondary infections with different serotypes, and fully protective vaccines and antiviral drugs are yet to be developed. Over the past decade, advances in antibody technology have led to the isolation of numerous monoclonal antibodies against dengue virus, with their neutralizing epitopes elucidated through structure-based analyses. This review highlights the key epitopes associated with neutralizing antibodies against dengue virus and discusses their potential applications in vaccine design and therapeutic antibody development. This review helps systematically summarize the progress in dengue virus neutralizing antibody research, providing a theoretical foundation and technical guidance for the development of novel vaccines and antibody therapeutics.
Dengue Virus/immunology* ; Antibodies, Neutralizing/immunology* ; Antibodies, Monoclonal/therapeutic use* ; Dengue/prevention & control* ; Humans ; Antibodies, Viral/immunology* ; Epitopes/immunology* ; Animals ; Dengue Vaccines/immunology*

Objective:b> To understand the basic characteristics of previously reported patients with hepatitis C and analyze the related factors affecting their antiviral treatment. Methods:b> A convenient sampling method was adopted. Patients who had been previously diagnosed with hepatitis C in the Wenshan Prefecture of Yunnan Province and Xuzhou City of Jiangsu Province were contacted by telephone for an interview study. The Andersen health service utilization behavior model and related literature were used to design the research framework for antiviral treatment in previously reported hepatitis C patients. A step-by-step multivariate regression analysis was used in previously reported hepatitis C patients treated with antiviral therapy. Results:b> A total of 483 hepatitis C patients, aged 51.73 ± 12.06 years, were investigated. The proportion of male, agricultural occupants who were registered permanent residents, farmers and migrant workers was 65.24%, 67.49%, and 58.18%, respectively. Han ethnicity (70.81%), married (77.02%), and junior high school and below educational level (82.61%) were the main ones. Multivariate logistic regression analysis results showed that married patients with hepatitis C (OR = 3.19, 95% CI: 1.93-5.25, compared with unmarried, divorced, and widowed patients) with high school education or above (OR = 2.54, 95% CI: 1.54-4.20, compared with patients with junior high school education or below) were more likely to receive antiviral treatment in the predisposition module. Patients with severe self-perceived hepatitis C in the need factor module (compared with patients with mild self-perceived disease, OR = 3.36, 95% CI: 2.09-5.40) were more likely to receive treatment. In the competency module, the family's per capita monthly income was more than 1,000 yuan (compared with patients with per capita monthly income below 1,000 yuan, OR = 1.59, 95% CI: 1.02-2.47), and the patients had a high level of awareness of hepatitis C knowledge (compared with patients with a low level of knowledge, OR = 1.54, 95% CI: 1.01-2.35), and the family members who knew the patient's infection status (compared with patients with an unknown infection status, OR = 4.59, 95% CI: 2.24-9.39) were more likely to receive antiviral treatment. Conclusion:b> Different income, educational, and marital statuses are related to antiviral treatment behavior in hepatitis C patients. Family support of hepatitis C patients receiving hepatitis C-related knowledge and their families knowing the infection status is more important in promoting the antiviral treatment of patients, suggesting that in the future, we should further strengthen the hepatitis C knowledge of hepatitis C patients, especially the family support of hepatitis C patients' families in treatment.
Humans ; Male ; Antiviral Agents/therapeutic use* ; China ; Hepatitis C/drug therapy* ; Hepacivirus ; Logistic Models

Objective:b> To understand the infection status and epidemiological characteristics of hepatitis C in people aged 1-69 years in Henan Province in 2020. Methods:b> The estimated sample size was 5 827. From August to December 2020, multistage sampling was used to select 8 counties (districts) in Henan, and two survey sites were selected in each county (district), and a questionnaire survey was conducted in local people aged 1-69 years, blood samples were collected from them for anti-HCV, HCV RNA and genotype detections. Results:b> A total of 5 165 people aged 1-69 years completed the questionnaire survey. Men accounted for 44.76% (2 312/5 165), women accounted for 55.24% (2 853/5 165). In the people aged 1-69 years, the overall prevalence rates of anti-HCV and HCV RNA were 0.69% (95%CI: 0.68%-0.70%) and 0.20% (95%CI: 0.19%-0.21%) respectively. The prevalence rates of anti-HCV and HCV RNA were 0.48% (95%CI: 0.46%-0.50%), 0.09% (95%CI: 0.08%-0.10%) in men and 0.86% (95%CI: 0.85%-0.87%), 0.30% (95%CI: 0.28%-0.32%) in women. The prevalence rates of anti-HCV and HCV RNA increased with age. The prevalence rates of anti-HCV and HCV RNA were 0.87% (95%CI: 0.86%-0.88%), 0.28% (95%CI: 0.26%-0.30%) in urban residents and 0.53% (95%CI: 0.51%-0.55%), 0.14% (95%CI: 0.13%-0.15%) in rural residents. The genotyping results of 10 HCV RNA positive samples ware genotype 1b (4/10), genotype 2 (3/10), genotype 1b/3 (1/10), genotype 1b/3/6 (1/10) and genotype 2/6 (1/10). Conclusions:b> The prevalence of hepatitis C was low in Henan in 2020. It is necessary to strengthen hepatitis C surveillance in people aged 40 years and above. The major HCV genotypes were 1b and 2, and mixed genotype infection existed.
Female ; Humans ; Male ; Coinfection ; Genotype ; Hepacivirus/genetics* ; Hepatitis C/epidemiology* ; Hepatitis C Antibodies/genetics* ; Prevalence ; RNA, Viral/genetics* ; Surveys and Questionnaires ; Infant ; Child, Preschool ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged

In the past 20 years, Chinese Medical Association had issued several versions of hepatitis C prevention and treatment guidelines. In the latest guidelines published in 2022, the Chinese Society of Hepatology and the Society of Infectious Diseases for the Chinese Medical Association organized experts to update their recommendations for hepatitis C screening and treatment. The updated key points on prevention, diagnosis, and treatment proposed in the guidelines are now interpreted, aiming to provide reference for more effective clinical application of the guidelines.
Humans ; Hepacivirus ; Hepatitis C/prevention & control* ; Mass Screening ; Asian People

BACKGROUND: Large disparities exist in liver cancer burden trends across countries but are poorly understood. We aimed to investigate the global trajectories of liver cancer burden, explore the driving forces, and predict future trends. METHODS: Data on the liver cancer burden in 204 countries and territories from 1990 to 2019 were extracted from the Global Burden of Disease Study. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) trajectories were defined using growth mixture models. Five major risk factors contributing to changes in the ASIR or ASMR and socioeconomic determinants were explored using the identified trajectories. A Bayesian age-period-cohort model was used to predict future trends through 2035. RESULTS: Three trajectories of liver cancer burden were identified: increasing, stable, and decreasing groups. Almost half of the American countries were classified in the decreasing group (48.6% for ASIR and ASMR), and the increasing group was the most common in the European region (ASIR, 49.1%; ASMR, 37.7%). In the decreasing group, the decrease of liver cancer due to hepatitis B contributed 63.4% and 60.4% of the total decreases in ASIR and ASMR, respectively. The increase of liver cancer due to alcohol use, hepatitis C, and hepatitis B contributed the most to the increase in the increasing group (30.8%, 31.1%, and 24.2% for ASIR; 33.7%, 30.2%, and 22.2% for ASMR, respectively). The increasing group was associated with a higher sociodemographic index, gross domestic product per capita, health expenditure per capita, and universal health coverage (all P <0.05). Significant variations in disease burden are predicted to continue through 2035, with a disproportionate burden in the decreasing group. CONCLUSION Global disparities were observed in liver cancer burden trajectories. Hepatitis B, alcohol use, and hepatitis C were identified as driving forces in different regions.
Humans ; Bayes Theorem ; Liver Neoplasms ; Risk Factors ; Hepatitis C/complications* ; Hepatitis B ; Hepacivirus ; Incidence