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Information on persistent EqHV infection and hepatitis is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To report 19 cases of chronic hepatitis and persistent EqHV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Mixed retrospective and prospective case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Inclusion criteria were: (1) chronic hepatitis, defined as persistently increased serum liver biomarkers, increased serum liver biomarkers accompanied by histopathological evidence of chronicity, for example, fibrosis, or both; (2) positive serum or liver EqHV RT\u2010qPCR; and (3) available liver histopathology. Horses were excluded if they became serum EqHV RT\u2010qPCR undetectable, died, or were euthanised within 6\u2009months of EqHV detection. Liver biopsies were independently reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010nine horses met inclusion criteria. Ten were subsequently excluded (two cleared EqHV, 8 died within 6\u2009months). For the remaining 19 horses, the median duration of documented hepatitis was 18.4 (range, 5.2\u2013120) months and documented EqHV viremia was 14.8 (range, 6.9\u201355.6) months. Histopathological findings mirrored those seen in humans with chronic HCV including fibrosis, lymphocytic infiltrate, lymphoid aggregates, and individual hepatocyte necrosis. One horse was diagnosed with bacterial cholangiohepatitis, and the remainder had no definitive etiologic diagnosis. Bacterial infection, equine parvovirus\u2010hepatitis infection, and equine multinodular pulmonary fibrosis were frequent comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Limitations<\/jats:title>\n                    <jats:p>A direct causal link between EqHV viremia and hepatitis cannot be made from these data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Some horses with persistent EqHV infection develop chronic hepatitis and liver failure, with clinical and histopathological findings resembling HCV in humans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/evj.70124","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T02:47:24Z","timestamp":1766717244000},"page":"444-457","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Chronic hepatitis in horses with persistent equine hepacivirus infection"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6036-9895","authenticated-orcid":false,"given":"Mason C.","family":"Jager","sequence":"first","affiliation":[{"name":"Department of Population Medicine and Diagnostic Sciences Cornell University College of Veterinary Medicine  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Luethy","sequence":"additional","affiliation":[{"name":"Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania  Kennett Square Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Shallop","sequence":"additional","affiliation":[{"name":"Department of Population Medicine and Diagnostic Sciences Cornell University College of Veterinary Medicine  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Cathcart","sequence":"additional","affiliation":[{"name":"Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania  Kennett Square Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7125-636X","authenticated-orcid":false,"given":"Thomas J.","family":"Divers","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Cornell University College of Veterinary Medicine  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2331-4478","authenticated-orcid":false,"given":"Jean\u2010Yin","family":"Tan","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine and Taylor Institute for Teaching and Learning, University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin McConachie","family":"Beasley","sequence":"additional","affiliation":[{"name":"University of Georgia College of Veterinary Medicine  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Johnson","sequence":"additional","affiliation":[{"name":"Equine Internal Medicine and Surgery, College of Veterinary Medicine, University of Missouri  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Leduc","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine v\u00e9t\u00e9rinaire Universit\u00e9 de Montr\u00e9al  Saint Hyacinthe Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Smith","sequence":"additional","affiliation":[{"name":"Sound Equine Veterinary Hospital  Pouslbo Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6080-2692","authenticated-orcid":false,"given":"Camilla Anne","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences Purdue University College of Veterinary Medicine  West Lafayette Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9988-3381","authenticated-orcid":false,"given":"K. 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