Viral hepatitis in 2021: The challenges remaining and how we should tackle them

Table 1 Recommendations for hepatocellular carcinoma surveillance in patients with hepatitis C virus achieving sustained virologic response

Guideline	Recommendation
EASL[114] 2020	Survey patients with advanced fibrosis (F3) or cirrhosis (F4)
AASLD[115]	Survey cirrhotic patients
Asia-Pacific[116]	Survey cirrhotic patients; Survey patients with any histologic stage of HCV with comorbidities, such as alcohol abuse and diabetes mellitus

HCV: Hepatitis C virus. AASLD: American Association for the Study of Liver Diseases; EASL: European Association for the Study of the Liver.

Table 2 Public health and research priorities for the next decade

Virus	Public health priorities	Research priorities
Hepatitis A	Increased vaccination of high-risk individuals; Improved sanitation and vaccination in camps for displaced persons	Medical treatments for those with acute liver failure
Hepatitis B	Increase uptake of vaccination; Identifying undiagnosed individuals; Linkage to care	Establishing treatment end-points; Identifying curative treatment
Hepatitis C	Microelimination; Reducing re-infection rates; Identifying undiagnosed individuals; Harm reduction	Vaccination; Confirming most effective HCC surveillance strategies
Hepatitis D	Identification of infected individuals; Clarifying current disease burden of HDV	Novel therapies
Hepatitis E	Increased screening of blood products/change in donor policies; Educating immunosuppressed patients of risk of food-borne transmission; Further understanding of sources of infection	RCT to confirm optimal dose and duration of ribavirin therapy; Novel treatments; Vaccination; Greater understanding of genetic mutations

HDV: Hepatitis D virus; HCC: Hepatocellular carcinoma; RCT: Randomized controlled trial.