Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2021; 27(26): 4018-4044
Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.4018
Viral hepatitis update: Progress and perspectives
María B Pisano, Cecilia G Giadans, Diego M Flichman, Viviana E Ré, María V Preciado, Pamela Valva
María B Pisano, Viviana E Ré, Virology Institute, CONICET, School of Medical Sciences, National University of Córdoba, Cordoba X5016, Argentina
Cecilia G Giadans, María V Preciado, Pamela Valva, Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP) CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children’s Hospital, CABA C1425, Buenos Aires, Argentina
Diego M Flichman, Institute of Biomedical Investigations in Retrovirus and AIDS (INBIRS), School of Medicine, University of Buenos Aires, CONICET, CABA C1121ABG, Buenos Aires, Argentina
Author contributions: Pisano MB and Ré VE collected the data for HAV and HEV and wrote these sections of the manuscript; Giadans CG and Flichman DM collected the data and wrote the HBV section; Preciado MV and Valva P collected data and wrote the HCV and HDV sections; Valva P edited the article. All authors made critical revisions and approved the final version of the article.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Pamela Valva, PhD, Senior Researcher, Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP) CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children’s Hospital, Gallo 1330, CABA C1425, Buenos Aires, Argentina.
Received: January 25, 2021
Peer-review started: January 25, 2021
First decision: March 29, 2021
Revised: April 11, 2021
Accepted: June 16, 2021
Article in press: June 16, 2021
Published online: July 14, 2021

Viral hepatitis, secondary to infection with hepatitis A, B, C, D, and E viruses, are a major public health problem and an important cause of morbidity and mortality. Despite the huge medical advances achieved in recent years, there are still points of conflict concerning the pathogenesis, immune response, development of new and more effective vaccines, therapies, and treatment. This review focuses on the most important research topics that deal with issues that are currently being solved, those that remain to be solved, and future research directions. For hepatitis A virus we will address epidemiology, molecular surveillance, new susceptible populations as well as environmental and food detections. In the case of hepatitis B virus, we will discuss host factors related to disease, diagnosis, therapy, and vaccine improvement. On hepatitis C virus, we will focus on pathogenesis, immune response, direct action antivirals treatment in the context of solid organ transplantation, issues related to hepatocellular carcinoma development, direct action antivirals resistance due to selection of resistance-associated variants, and vaccination. Regarding hepatitis D virus, we describe diagnostic methodology, pathogenesis, and therapy. Finally, for hepatitis E virus, we will address epidemiology (including new emerging species), diagnosis, clinical aspects, treatment, the development of a vaccine, and environmental surveillance.

Keywords: Viral hepatitis, Hepatitis A virus, Hepatitis B virus, Hepatitis C virus, Hepatitis D virus, Hepatitis E virus

Core Tip: Viral hepatitis is a global public health concern that affects millions of people and causes thousands of deaths due to acute and chronic infections, cirrhosis, and liver cancer. Although clinical and epidemiological characteristics of hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus, and hepatitis E virus infections are widely known, there are still other critical points that need to be discussed. This review focuses on the most important research topics, dealing unsolved issues and future research directions that can maximize practical impact in the field of viral hepatitis.