Background/Objectives: The objective of this study was to analyze the results of clinical trials regarding long-term antiviral therapies in chronic hepatitis with HBV to compare current therapeutic protocols and to analyze the results of preliminary studies with new antiviral therapies for HBV. Methods: Clinical studies and meta-analyses from PubMed, Google Scholar, and Research Gate from 2011 to 2024 were analyzed on patients undergoing chronic antiviral therapy for HBV, and a retrospective observational study performed in our clinic on a group of 76 patients undergoing chronic therapy with entecavir was presented. Also, a summary of the results of preliminary studies with various innovative antiviral molecules for HBV was performed. Results: The results of extensive clinical trials reveal that current therapies for chronic HBV are well tolerated and maintain good viral suppression if the patient is adherent to therapy. Innovative therapies aim to eliminate HBsAg and, thus, significantly shorten the duration of treatment, and the preliminary results of the studies are promising. Conclusions: Being an asymptomatic condition that requires life-long therapy, adherence to therapy is a real problem. Also, the risk of decompensation of liver cirrhosis and adenocarcinoma remains important in these patients. Future research is needed to perfect some antiviral therapy schemes that shorten the treatment period but also decrease the rate of progression towards decompensated cirrhosis and liver adenocarcinoma.

Background: Depression is a significant global mental health concern, especially among medical students. This study combines two components: (1) a cross-sectional assessment of depression and related psychological and demographic factors among students at “Dunărea de Jos” University of Galați, and (2) a systematic review and meta-analysis of published Romanian studies on depression in medical students. Methods: For the cross-sectional component, 495 students (Years I–III) completed online questionnaires assessing depressive symptoms (PHQ-9), personality traits, procrastination, and sociodemographic factors. In the systematic review, studies from PubMed and Web of Science were synthesized following PRISMA guidelines, with prevalence data being pooled via random-effects meta-analysis. Results: In the Galați sample, 34.0% of students had clinically significant depressive symptoms (PHQ-9 ≥ 10). Depression was associated with female gender, being in the third year of study, low social support, high neuroticism, and procrastination. The meta-analysis (six studies, N = 1546) yielded a pooled national prevalence of 19.99% (95% CI: 18.24–21.73%). Conclusions: Depression is highly prevalent among Romanian medical students, particularly in Galați. The findings support the need for targeted mental health interventions in Romanian universities. Registration: This systematic review has been registered in the Prospero database (registration number CRD420251056873).

Background/Objectives: Chronic hepatitis C virus (HCV) infection is associated with a wide spectrum of extrahepatic manifestations, involving the immune, dermatologic, endocrine, vascular, and neuropsychiatric systems. Among these, mixed cryoglobulinemic vasculitis (CryoVas) remains one of the most clinically relevant complications. This work aims to provide a structured overview of HCV-related extrahepatic conditions and to analyze the clinical and virological outcomes of direct-acting antivirals (DAAs) in CryoVas patients. Methods: We first categorized and reviewed extrahepatic manifestations of HCV across five major domains: immune, inflammatory/metabolic/vascular, dermatological, thyroid, and neuropsychiatric. Subsequently, we conducted a comparative analysis of five clinical studies evaluating the impact of DAA therapy in patients with CryoVas. Data on demographics, clinical symptoms, treatment regimens, sustained virological response, and clinical response were extracted and summarized. Results: HCV was found to be associated with numerous extrahepatic conditions, including mixed cryoglobulinemia, non-Hodgkin lymphoma, autoimmune thyroiditis, insulin resistance, and neurocognitive symptoms. In the CryoVas subgroup analysis, virological response rates were uniformly high (88.9–100%), but clinical remission varied significantly. Complete response ranged from 39% to 90%, highlighting a discrepancy between viral eradication and extrahepatic symptom resolution. These findings underscore the need for individualized follow-up and further investigation into persistent immunological dysfunction post-sustained virological response (SVR). However, clinical outcomes were more variable: complete response (CR) varied between 39% and 90%, partial response (PR) ranged from 4% to 42%, and no response (NR) was reported in 0% to 40% of cases. Although significant improvement in key manifestations such as purpura, arthralgia, and neuropathy was frequently observed, a subset of patients continued to exhibit residual or refractory symptoms despite achieving SVR. Conclusions: HCV infection exerts multisystemic effects that extend beyond liver pathology. While DAAs offer near-universal virological clearance, the heterogeneous clinical response in CryoVas underscores the need for closer monitoring of extrahepatic outcomes. Future research should assess whether combining DAAs with immunomodulatory strategies can improve symptom control and long-term outcomes in patients with severe or refractory CryoVas.

Background/Objectives: Measles is a highly contagious viral disease that continues to have a profound effect on morbidity in Romania. Identifying temporal and spatial trends in how the disease spreads among the country’s counties and regions, both in the same disease generation as well as one generation apart (2-week case lag), aided by forecasting tools, could provide valuable insights into tailoring public health interventions. Methods: A big data analysis has been performed on notified measles cases from January 2020 to December 2024 using Python v3.13 grouping cases based on location (using the Nomenclature of territorial units for statistics) and time of the onset of the disease. Results: Feedback loops among both counties and macroregions have been identified (for example Centru-Brașov and București-Ilfov with a correlation factor of 0.77) while monthly forecasting for 2025 and 2026, explored using both the SARIMA and the Holt-Winters models (MAE 1616.74 and 1281.99, respectively), shows the measles might continue to be a burden, with the Holt–Winters models exhibiting slightly more reliable monthly forecast data nationwide, helping to define a solid basis for future predictions and decisions. Conclusions: The spatial feedback loops, both interregional or within the same region, coupled with the trend of lowering vaccination rates, contribute to the persistent emergence of new measles cases which might continue throughout 2025 and 2026 based on the forecasting, distinct from previous outbreaks which followed a specific cadence.

Purpose: This article aims to harmonize the current data from the literature, describe baseline severity, and discuss potential treatment considerations for cases of triple infection. Patients and Methods: We undertook a retrospective, observational study on 1244 patients with viral hepatitis study subgroups: chronic replicative hepatitis with HCV—679 patients, HBV—98 patients, HBV/HCV—25 patients, HBV/HDV—14 patients, and 2 patients with triple-infection (HBV, HCV, and HDV), hospitalized in the Second Department of “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital of Galați, Romania, between 1 April 2017 and 1 March 2025. Results: Comparative analysis of biochemical parameters and liver fibrosis—at the initial testing—i.e., at the beginning of the specific antiviral therapy—with direct-acting antivirals on HCV (DAAs) or nucleos(t)ide analogues (NUCs): Entecavir (ETV) or Tenofovir Disoproxyl fumarate (TDF), for HBV, Bulevirtide (BLV) for HDV—revealed clinical forms with higher severity in the case of triple and double infections, in comparison to individuals who have had only one hepatotropic virus infection. Conclusions: Compared to patients with a single hepatotropic viral infection, those with a double or triple infection had more severe hepatic damage. Concomitant therapy with Bulevirtide, DAAs, and NUCs is possible and the therapeutic results from clinical studies, with single-infection patients showing great potential for improving the prognosis of these patients.

Background and objectives: During an outbreak, measles cases tend to aggregate into increasingly bigger clusters that show specific characteristics, different from the non-cluster cases. As the measles threat continues throughout Europe in 2025 with a high notification rate in Romania as well, exploring how clustering affects the disease propagation can provide additional insights into how to improve measles surveillance and control. Methods: National measles cases from 2020 to 2024 have been split into cluster (at least three related cases) and non-cluster-related cases and analyzed comparatively based on vaccination status, disease-related data (hospitalization) and patient-related data (age, location). Large outbreaks with at least 150 cases, allowing for more comprehensive R₀ analysis, have been described and the basic reproduction numbers computed for each of them. Results: There are statistically significant differences in vaccination status, age, and hospital stay between outbreak and non-outbreak cases. Large outbreaks (≥150 cases) show a high degree of variability, with R₀ values varying from as low to 1 to as high as 3.92, indicating limited measles transmission control. Conclusions: The findings in this research highlight the critical impact of clustering on measles transmission dynamics during outbreaks. Significant differences in vaccination status, age, and hospitalization rates between cluster and non-cluster cases underscore the importance of targeted surveillance and intervention strategies while the wide range of R₀ values observed in large outbreaks points to inconsistent control measures and emphasizes the need for strengthened vaccination campaigns and improved outbreak response protocols to better contain measles spread.