Hepatitis B virus (HBV) infection is a major cause of acute and chronic liver disease and associated morbidity and mortality worldwide. Vertical and early childhood transmission are the main routes of HBV transmission globally, responsible for most chronic infectionsincluding in adults who bear the greatest burden of morbidity and mortality. Universal infant and birth dose hepatitis B immunization is the key preventative strategy for global elimination of HBV infection, and has been highly effective in reducing new vertical infections. Global progress on HBV testing and treatment, however, has been slow in adults and children. In this review, we summarize current knowledge on epidemiology, natural history, and treatment of chronic HBV infection in adolescents and children, highlighting key differences from the experience with adults, and conclude with key actions to address current policy gaps. The estimated global prevalence in children aged 5 years or less is 1.3%. Most children are in the "high replication, low level of inflammation" infection phase with normal or only minimally raised aminotransferases; cirrhosis and hepatocellular carcinoma are rare. Although entecavir is approved and recommended for children 2 to <18 years, and tenofovir for those 12 to < 18 years, a conservative approach to treatment initiation is currently recommended. Key actions to address current policy gaps include: validation of non-invasive tests for liver disease staging; additional immunopathogenesis studies in HBV infected children, and long-term follow-up of children on nucleoside analogue regimens to inform guidance on when to start treatment; evaluation of different treatment strategies for children with high levels of replication; and establishment of paediatric treatment registries and international consortia to promote collaborative research.

Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and associated morbidity and mortality worldwide. Short-course, oral, curative, direct-acting antiviral regimens have now transformed treatment for HCV infection. Since the launch in 2016 of the first global strategy towards elimination of viral hepatitis as a public health threat by 2030, the predominant focus of the global response has been on treatment of adults, who bear the greatest burden of morbidity and mortality of HCV related chronic liver disease. There has been much less attention paid to addressing response to HCV in children and adolescents, in part because of the lack of data to inform specific paediatric management practices and policy. In this review, we summarize current knowledge on epidemiology, natural history, and treatment of chronic HCV infection in adolescents and children, and highlight key differences from infection acquired in adulthood. The estimated global prevalence and burden in children aged 1 to 19 years is 0•15% and 3•5 (3•1-3•9) million, respectively. HCV infection is usually asymptomatic during childhood, and cirrhosis and hepatocellular carcinoma are rare. Sofosbuvir, ledipasvir and ribavirin have now received regulatory approval and guidelines recommend their use in adolescents ages >12 years with HCV infection. Key actions to address the current policy gaps and achieve treatment scale-up comparable to that in adults include: establishment of a testing and treatment access campaign targeted at children and adolescents; fast-track evaluation of pangenotypic regimens and accelerated approval of paediatric formulations. Research gaps that need to be addressed include age-specific seroprevalence studies of HCV viraemia in priority countries; further validation of non-invasive tests in children; and establishment of paediatric treatment registries and international consortia to promote collaborative research agenda.

The results suggest an association between increased iron stores and glucose intolerance at the third trimester in non-anaemic women. The role of iron excess in the pathogenesis of GDM needs to be examined.

BackgroundDespite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China.MethodsWe searched MEDLINE, EMBASE and the Cochrane Library for recent studies on MSM/TG HIV epidemiology and responses. We also included supplemental articles, grey literature, government reports, policy documents, and best practice guidelines.ResultsOverall, HIV prevalence among Chinese MSM was approximately 8 % in 2015 with a higher prevalence observed in Southwest China. TG are not captured in national HIV, STD, or other sexual health surveillance systems. There is limited data sharing between the public health authorities and community-based organizations (CBOs). Like other low and middle income countries, China is challenged by low rates of HIV testing, linkage, and retention. Several pilot interventions have been shown to be effective to increase HIV testing among MSM and TG individuals, but have not been widely scaled up. Data from two randomized controlled trials suggests that crowdsourcing contests can increase HIV testing, creating demand for services while engaging communities.ConclusionImproving HIV surveillance and expanding HIV interventions for Chinese MSM and TG individuals are essential. Further implementation research is needed to ensure high-quality HIV services for MSM and TG individuals in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1904-5) contains supplementary material, which is available to authorized users.