28 July is used to recognise World Hepatitis Day.
Why is World Hepatitis Day needed?
For World Hepatitis Day we consider the 47 million people globally who are living with hepatitis C. Most of them don’t know they have it and some of those who do struggle with current treatment options.
As explained by the World Health Organisation (WHO), Hepatitis C is inflammation of the liver caused by hepatitis C virus. The virus can cause hepatitis that ranges in severity from mild illness to serious, lifelong illness including liver cirrhosis and cancer. 76% of liver cancer cases are caused by hepatitis.
We already have everything we need to eliminate hepatitis by 2030. What we need is action.
They explain that stigma and discrimination, financial constraints, weak health-system integration, and inequitable access to innovation continue to leave millions living with hepatitis without care.
Their page for World Hepatitis Day 2026 highlights that everyone should be able to benefit from WHO-recommended hepatitis treatment. It’s essential that access for underserved and vulnerable populations is expanded through people-centred, integrated service delivery to reduce inequalities.
Why do CELT Global Health recognise World Hepatitis Day?
Hepatitis C virus infection occurs in all WHO regions, but the highest burden of disease is in the Eastern Mediterranean, the South-East Asia, European, African and Western Pacific Regions. These regions include many low- and middle- income countries (LMICs). Hepatitis C virus is treatable, but current treatment plans are either not reaching or are unmanageable for many people living with the disease in these LMICs.
The Centre of Excellence for Long-acting Therapeutics – Global Health (CELT Global Health), overseen for co-directors Professor Andrew Owen and Professor Steve Rannard, heads the LONGEVITY project funded by global health agency Unitaid. LONGEVITY is a consortium of experts working to create long-acting versions of existing medicines for key diseases including hepatitis C virus.
What is LONGEVITY’s hepatitis C virus work?
The pill burden associated with treating hepatitis C virus is part of why so many patients are unable to keep up with their medication. For a full 8-12 week treatment that’s up to 168 pills to organise, remember and keep up with at specific time intervals alongside daily life and responsibilities. It’s understandable how this can be challenging.
We believe that long-acting versions of these medicines could be part of the answer to overcoming issues with adherence to oral pills. If we can create and get a long-acting treatment that last 8-12 weeks to people living with hepatitis C virus, that would be a one-shot-cure. It would also mean patients would have the option to be treated as soon as they are diagnosed.
We have made sure this idea aligns to patient preferences and community involvement is a key aspect of LONGEVITY. Treatment Action Group and the Long-acting Technology Community Advisory Board presented ‘Surveys on Preferences and feasibility of Long-Acting Technologies for the treatment of Hepatitis C Virus’ at this year’s World Hepatitis Summit, have presented a recorded community engagement webinar of the findings and published a patient preferences article. We might think that long-acting options will help, but we needed to know that relevant communities agreed.
LONGEVITY’s experts cover a range of expertise because the main consideration of our work is for any medication that comes from LONGEVITY are prioritised to patients in the LMICs where the disease has the biggest impact.
CROI 2026
For the last two years our World Hepatitis Day content has spotlighted LONGEVITY presentations at the Conference of Retroviruses and Opportunistic Infections (CROI). In 2024 we presented work on our long-acting liquid injectable and last year we presented our long-acting solid injectable findings. For 2026 Dr Usman Arshad returned to CROI to present LONGEVITY hepatitis C virus work, so we spoke to him about this year’s presentation.
What was our CROI poster presentation about?
My presentation at CROI 2026 focused on a major obstacle in global health: curing hepatitis C virus (HCV). While we currently have highly effective oral medications - specifically the combination of glecaprevir and pibrentasvir - patients must take them daily for several weeks. In many parts of the world, strict adherence to a daily tablet regimen is exceedingly difficult due to lack of resources, stigma, or the chaotic nature of patients' daily lives. My poster outlined our work at CELT Global Health to solve this by creating a long-acting injectable. Our goal is to take the entire multi-week course of treatment and condense it into a single, long-lasting injection - effectively creating a "one-shot-cure" for HCV.
How did we go about the work?
Creating a long-acting injection isn't as simple as just putting the drugs into a syringe. We had to use nanotechnology to reformulate the drugs. We previously knew that combining these two specific drugs (glecaprevir and pibrentasvir) into an injectable format worked surprisingly well (CROI 2024), but we didn't know exactly why. To figure it out, we tested three different architectures of the medicine in preclinical models. We compared what happens when you formulate the two drugs into separate nanoparticles and mix them together, versus what happens when you co-formulate them—trapping both drugs inside the exact same individual nanoparticles.
What were the findings and what do they mean?
When we mixed separate particles together, the injection failed to maintain the required drug levels over time. However, when the two drugs were locked together inside the same nanoparticle (our co-formulated approach), it was highly successful. The drugs maintained therapeutic levels in the bloodstream for 8 weeks from a single injection. What this means scientifically is that we discovered a phenomenon we call "mutual dissolution modulation." Because the two drugs have different solubilities, forcing them to sit next to each other inside the same particle causes them to regulate each other. The slow-dissolving pibrentasvir acts like a brake, stopping the fast-dissolving glecaprevir from releasing too quickly. Conversely, the highly soluble glecaprevir acts like a sponge, drawing fluid into the particle to help wet and dissolve the poorly soluble pibrentasvir, significantly increasing the overall drug levels achieved in the bloodstream. It proves that the physical architecture of a nanoparticle is just as critical to its success as the chemistry of the drugs themselves.
How were the poster findings different to previous years?
In previous years, our focus was largely on proving that a long-acting injectable for HCV was possible. We had demonstrated the initial pharmacokinetic benefits of combining these drugs. This year's presentation was different because it moved from observation to mechanism. We aren't just showing that it works; we have now proved how and why it works at a nanoparticle level. By ruling out biological interactions and proving that this is a physicochemical effect happening inside the formulation itself, we have a clear blueprint for how to design these long-acting medicines more effectively.
Why is it important for global health / what is the patient benefit of the findings?
The goal of this research is health equity. A daily tablet works wonders, but only if you have the stability and support to take it every day. For many vulnerable populations disproportionately affected by HCV, such as people who inject drugs or those without stable housing, a daily regimen is a barrier to a cure. By developing a "one-shot" long-acting injectable, we remove the burden of daily adherence entirely. A patient could receive a single injection at a clinic and walk out knowing they are on the path to being cured, without needing to manage a month's worth of tablets. Furthermore, this "co-formulation" strategy we identified isn't just for hepatitis C; it represents a platform technology that could be applied to treatments for HIV, Malaria or Tuberculosis. Ultimately, this work is about simplifying treatment to ensure that life-saving cures reach the people who need them most, regardless of their circumstances.
#WorldHepatitisDay
LONGEVITY aims to simplify hepatitis C virus, malaria and tuberculosis treatment and preventative treatment to reduce the drug burden and the number of patients requiring complex therapies for active disease.
Find out more about the LONGEVITY project
The LONGEVITY Project is funded by global health agency Unitaid.
The project also involves critical partners and collaborators in the Clinton Health Access Initiative, Extentus Pharma Ltd, Johns Hopkins University, Medicines Patent Pool, Queen's University Belfast, Treatment Action Group and the University of Nebraska Medical Center.
