Journal Article Review Epublish
PubMed: 42655679 DOI: 10.3390/v18080861
Integrated Diagnosis of Hepatitis B, C, and D Viruses and HIV in Populations Evaluated for Sexually Transmitted Infections: A Narrative Review and Operational Framework.
Viruses 18(8)
Authors: Joaquín Cabezas, Ezequiel Ridruejo, José Antonio Velarde-Ruiz Velasco, Graciela Castro-Narro, Lorena Cayón-González, Carolina Jiménez, Hugo Cheinquer, Fernando Contreras, Nelia Hernández, Christie Perelló, José Luis Calleja, Javier Crespo
Affiliations
- Gastroenterology and Hepatology Department, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain.
- Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), 39008 Santander, Spain.
- Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Ciudad Autónoma de Buenos Aires C1425ASG, Argentina.
- Servicio de Gastroenterología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara 44280, Mexico.
- Unidad de Hepatología y Trasplante, Hospital Médica Sur, Ciudad de México 14050, Mexico.
- Departamento de Gastroenterología, Hepatología y Trasplante, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico.
- Departamento de Medicina Interna, Facultade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre 90040-060, Brazil.
- Hepatology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil.
- Centro de Gastroenterología Avanzada de Santo Domingo, Santo Domingo 10148, Dominican Republic.
- Gastroenterology Academic Unit, Hospital de Clínicas, Faculty of Medicine, Universidad de la República (UdelaR), Montevideo 11200, Uruguay.
- Unidad de Hepatología, Centro de Estudios Digestivos, Hospital Metropolitano Santiago (HOMS), Santiago de los Caballeros 51000, Dominican Republic.
- Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, 28222 Madrid, Spain.
- Valdecilla Research Institute (IDIVAL), Universidad de Cantabria, 39008 Santander, Spain.
- MedicineAI Association, 28027 Madrid, Spain.
Abstract
Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV), together with HIV and bacterial sexually transmitted infections (STIs), account for a rising toll of more than one million deaths annually and overlap within shared behavioral and social networks, yet are still diagnosed through separate, pathogen-specific pathways. This narrative review synthesizes contemporary evidence on the convergence between viral hepatitis, HIV, and high-risk STI groups-men who have sex with men, pre-exposure prophylaxis (PrEP) users, people practicing chemsex, people who inject drugs, incarcerated populations, and migrants from endemic regions-and characterizes the diagnostic technologies and linkage-to-care models available to address it. Despite effective antivirals, the diagnostic cascade remains the principal bottleneck: most people with chronic HCV are undiagnosed, and HDV-with a pooled anti-HDV seroprevalence of approximately 4.5% among HBsAg-positive individuals-is its clearest expression, as most carriers are never tested. Reflex algorithms, multiplex panels, point-of-care assays, dried blood spots, and electronic health record alerts are validated but unevenly implemented. We argue that, alongside persistent resource, political, and equity-related constraints, a substantial share of the remaining barriers is operational rather than purely technological, and propose a practical, STI-clinic-centered framework integrating reflex testing, population-specific periodicity, and explicit linkage pathways toward the WHO 2030 elimination targets.
MeSH
Sexually Transmitted Diseases, Pre-Exposure Prophylaxis, Virology, Hiv, Viruses, Sex, Diagnosis, Hepatitis B, Infections, Hepatitis, Chemsex