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- Title
Chronic Viral Hepatitis in Elite Athletes: Approaches to Risk Assessment, Prevention and Management.
- Authors
Mak, Lung-Yi; Beasley, Ian; Kennedy, Patrick T. F.
- Abstract
Elite athletes who participate in contact sports are at risk of bleeding injuries, leading to transmission of blood-borne viruses including hepatitis type B, C and D (HBV, HCV and HDV) capable of causing chronic liver disease, liver failure and liver cancer. In view of the significant advances in the viral hepatitis field over the past decade, more structured approaches should be in place to screen for and manage viral hepatitis in elite athletes. HBV status should be assessed in all elite athletes, and those infected should receive nucleos(t)ide analogues for viral suppression, while uninfected individuals should receive HBV vaccination. The all-oral direct acting antivirals for HCV are highly effective and safe, thus the remaining challenge with hepatitis C is case identification and linkage to care. HDV is only found in HBV-infected individuals, which is characterized by rapid disease progression and higher rates of cirrhosis and liver cancer in infected subjects. Pegylated interferon was the mainstay of treatment for HDV infection until bulevirtide, a viral entry inhibitor, was recently approved by the European Union (EMA) and FDA in America, while multiple novel therapies are already in clinical trials as part of the HBV cure program. Overall, awareness of chronic viral hepatitis in athletes should be improved. Prevention remains the cornerstone of the management of viral hepatitis in sport coupled with rigorous disease assessment in infected individuals, and antiviral therapy where indicated.
- Subjects
PREVENTION of infectious disease transmission; CHRONIC disease risk factors; PREVENTION of chronic diseases; HEPATITIS transmission; HEPATITIS C treatment; HEPATITIS C prevention; CHRONIC disease treatment; THERAPEUTIC use of interferons; HEPATITIS treatment; HEPATITIS C risk factors; HEPATITIS C diagnosis; HEPATITIS C transmission; HEPATITIS prevention; VIRAL antigens; VACCINES; VIRAL hepatitis; HEPATITIS; ANTIVIRAL agents; HEPATITIS C; RISK assessment; PREVENTIVE health services; CONTACT sports; UNIVERSAL precautions (Health); HEPATITIS D; DISEASE management; CHRONIC hepatitis B; DISEASE risk factors; INFECTIOUS disease transmission
- Publication
Sports Medicine - Open, 2022, Vol 8, Issue 1, p1
- ISSN
2199-1170
- Publication type
Article
- DOI
10.1186/s40798-022-00517-9