Ming-Lun Yeh1,2,3, Chung-Feng Huang2,3, Meng-Hsuan Hsieh2,3,4, Yu-Min Ko2, Kuan-Yu Chen2, Ta-Wei Liu2, Yi-Hung Lin2, Po-Cheng Liang2, Ming-Yen Hsieh2, Zu-Yau Lin2,3, Shinn-Cherng Chen2,3, Ching-I Huang2, Jee-Fu Huang2,3,5, Po-Lin Kuo1, Chia-Yen Dai1,2,3,5,4, Ming-Lung Yu2,3,5,6,7, Wan-Long Chuang2,3,5. 1. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 2. Hepatitis Center and Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 3. School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 4. Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 5. Lipid Science and Aging Research Center, and Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan. 6. Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan. 7. Liver Center, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
BACKGROUND AND AIM: Hepatitis B virus (HBV) may reactivate when treating chronic hepatitis C (CHC) with direct acting antivirals (DAA). We aim to investigate the risk of HBV reactivation during DAA therapy. METHODS: Chronic hepatitis C patients receiving pan-oral DAA therapy from December 2013 to August 2016 were evaluated. Fifty-seven patients that had a past HBV infection (negative hepatitis B surface antigen [HBsAg] and positive hepatitis B core antibody) and seven patients that had a current HBV infection (positive HBsAg) were enrolled. Serum HBV and hepatitis C virus (HCV) markers were regularly measured. The endpoints were the HCV sustained virological response (SVR) and the HBV virological/clinical reactivation. RESULTS: The overall SVR12 rate was 96.9%, and two patients, one with positive HBsAg, had a relapse of HCV. No episodes of HBV virological reactivation were observed among the patients with a past HBV infection. For the seven patients with a current HBV infection, HBV virological reactivation was found in four (57.1%) of the seven patients. Clinical reactivation of HBV was observed in one patient with pretreatment detectable HBV DNA and recovered after entecavir administration. For the other three patients with HBV virological reactivation, the reappearance of low level HBV DNA without clinical reactivation was observed. HBsAg levels demonstrated only small fluctuations in all the patients. CONCLUSIONS: There was a minimal impact of hepatitis B core antibody seropositivity on HCV efficacy and safety. For CHC patients with current HBV infection, the risk of HBV reactivation was present, and monitoring the HBV DNA level during therapy is warranted.
BACKGROUND AND AIM: Hepatitis B virus (HBV) may reactivate when treating chronic hepatitis C (CHC) with direct acting antivirals (DAA). We aim to investigate the risk of HBV reactivation during DAA therapy. METHODS:Chronic hepatitis Cpatients receiving pan-oral DAA therapy from December 2013 to August 2016 were evaluated. Fifty-seven patients that had a past HBV infection (negative hepatitis B surface antigen [HBsAg] and positive hepatitis B core antibody) and seven patients that had a current HBV infection (positive HBsAg) were enrolled. Serum HBV and hepatitis C virus (HCV) markers were regularly measured. The endpoints were the HCV sustained virological response (SVR) and the HBV virological/clinical reactivation. RESULTS: The overall SVR12 rate was 96.9%, and two patients, one with positive HBsAg, had a relapse of HCV. No episodes of HBV virological reactivation were observed among the patients with a past HBV infection. For the seven patients with a current HBV infection, HBV virological reactivation was found in four (57.1%) of the seven patients. Clinical reactivation of HBV was observed in one patient with pretreatment detectable HBV DNA and recovered after entecavir administration. For the other three patients with HBV virological reactivation, the reappearance of low level HBV DNA without clinical reactivation was observed. HBsAg levels demonstrated only small fluctuations in all the patients. CONCLUSIONS: There was a minimal impact of hepatitis B core antibody seropositivity on HCV efficacy and safety. For CHCpatients with current HBV infection, the risk of HBV reactivation was present, and monitoring the HBV DNA level during therapy is warranted.
Authors: Mohamed S Abdelbary; Reham Samir; Saeed M El-Nahaas; Rasha M H Shahin; Mohammad El-Sayed; Yasmine Gaber; Omnia Tantawi; Naglaa A Zayed; Ayman Yosry Journal: J Clin Exp Hepatol Date: 2022-05-05
Authors: Robert Flisiak; Waldemar Halota; Jerzy Jaroszewicz; Jacek Juszczyk; Piotr Małkowski; Małgorzata Pawłowska; Anna Piekarska; Krzysztof Simon; Krzysztof Tomasiewicz; Marta Wawrzynowicz-Syczewska Journal: Clin Exp Hepatol Date: 2017-05-10