Elisabetta Loggi1, Stefano Gitto2, Silvia Galli3, Mario Minichiello3, Fabio Conti2, Elena Grandini2, Alessandra Scuteri2, Giovanni Vitale2, Roberto Di Donato2, Carmela Cursaro2, Giuliano Furlini3, Pietro Andreone4. 1. Dipartimento di Scienze Mediche e Chirurgiche & Centro Studi Ricerche sulle Epatiti, Programma Dipartimentale ITEC, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy; Unità Operativa di Microbiologia e Virologia, Azienda Ospedaliero-Universitaria Sant'Orsola-Malpighi, Bologna, Italy. 2. Dipartimento di Scienze Mediche e Chirurgiche & Centro Studi Ricerche sulle Epatiti, Programma Dipartimentale ITEC, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy. 3. Unità Operativa di Microbiologia e Virologia, Azienda Ospedaliero-Universitaria Sant'Orsola-Malpighi, Bologna, Italy. 4. Dipartimento di Scienze Mediche e Chirurgiche & Centro Studi Ricerche sulle Epatiti, Programma Dipartimentale ITEC, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy. Electronic address: pietro.andreone@unibo.it.
Abstract
BACKGROUND: Hepatitis B (HBV) reactivation in chronic hepatitis C (CHC) patients treated with IFN-free direct acting antiviral (DAA) therapies has recently emerged as a potential risk. Given the potential burden of this issue, further data are needed to establish its actual clinical impact. OBJECTIVES: The aim of the present study was to analyze the occurrence of HBV reactivation in a cohort of CHC patient treated with DAAs in routine clinical practice. STUDY DESIGN: Consecutive CHC patients with different genotypes, treated with DAA between January 2015 and January 2016 were included in the study. Subjects had been tested for HBsAg and anti-HBc antibodies before antiviral therapy. HBV-DNA levels were examined in anti-HBc positive patients at baseline and 24 weeks after the end of treatment. Post-treatment HBsAg determination was performed in case of HBV-DNA positivity. Serum anti-HBs kinetics was analysed in anti-HBs and anti-HBc positive subjects. RESULTS: A cohort of 137 consecutive HCV patients treated with IFN-free regimens in routine clinical practice was evaluated. From this cohort, plasma samples of 44 subjects with positive serology for HBV (anti-HBc positive) were tested for HBV-DNA levels at baseline and 24 weeks after the end of treatment. Two of them were HBsAg-positive, while the others had signs of a past HBV exposure (HBsAg-negative±HBsAb-positive). No reactivation was found in HBcAb-positive and HBsAg-negative subjects. In the two HBsAg-positive, one experienced an increase in HBV-DNA levels of ≥2 log10 IU/mL during treatment. However, the reactivation was without clinical impact and, most important, was followed by HBsAg loss. CONCLUSIONS: Based on our experience, a past HBV infection seems not to be a condition predisposing to HBV reactivation. On the contrary, in HBsAg-positive subjects not in suppressive treatment with nucleos(t)ide analogs, regular monitoring of HBV-DNA during and after DAA treatment should be considered.
BACKGROUND:Hepatitis B (HBV) reactivation in chronic hepatitis C (CHC) patients treated with IFN-free direct acting antiviral (DAA) therapies has recently emerged as a potential risk. Given the potential burden of this issue, further data are needed to establish its actual clinical impact. OBJECTIVES: The aim of the present study was to analyze the occurrence of HBV reactivation in a cohort of CHCpatient treated with DAAs in routine clinical practice. STUDY DESIGN: Consecutive CHCpatients with different genotypes, treated with DAA between January 2015 and January 2016 were included in the study. Subjects had been tested for HBsAg and anti-HBc antibodies before antiviral therapy. HBV-DNA levels were examined in anti-HBc positive patients at baseline and 24 weeks after the end of treatment. Post-treatment HBsAg determination was performed in case of HBV-DNA positivity. Serum anti-HBs kinetics was analysed in anti-HBs and anti-HBc positive subjects. RESULTS: A cohort of 137 consecutive HCVpatients treated with IFN-free regimens in routine clinical practice was evaluated. From this cohort, plasma samples of 44 subjects with positive serology for HBV (anti-HBc positive) were tested for HBV-DNA levels at baseline and 24 weeks after the end of treatment. Two of them were HBsAg-positive, while the others had signs of a past HBV exposure (HBsAg-negative±HBsAb-positive). No reactivation was found in HBcAb-positive and HBsAg-negative subjects. In the two HBsAg-positive, one experienced an increase in HBV-DNA levels of ≥2 log10 IU/mL during treatment. However, the reactivation was without clinical impact and, most important, was followed by HBsAg loss. CONCLUSIONS: Based on our experience, a past HBV infection seems not to be a condition predisposing to HBV reactivation. On the contrary, in HBsAg-positive subjects not in suppressive treatment with nucleos(t)ide analogs, regular monitoring of HBV-DNA during and after DAA treatment should be considered.
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: Farina M Hanif; Zain Majid; Nasir Hassan Luck; Abbas Ali Tasneem; Syed Muddasir Laeeq; Muhammed Mubarak Journal: World J Hepatol Date: 2022-04-27
Authors: Lisa Townshend-Bulson; Elena Roik; Youssef Barbour; Dana J T Bruden; Chriss E Homan; Hannah G F Espera; Timothy J Stevenson; Annette M Hewitt; Wileina Rhodes; James E Gove; Julia N Plotnik; Mary M Snowball; John McGilvray; Brenna C Simons; Janet M Johnston; Brian J McMahon Journal: PLoS One Date: 2021-12-02 Impact factor: 3.240