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Sustained hepatitis C virus clearance and increased hepatitis B surface antigen seroclearance in patients with dual chronic hepatitis C and B during posttreatment follow‐up
Author(s) -
Yu MingLung,
Lee ChuanMo,
Chen ChiLing,
Chuang WanLong,
Lu ShengNan,
Liu ChenHua,
Wu ShunSheng,
Liao LiYing,
Kuo HsingTao,
Chao YouChen,
Tung ShuiYi,
Yang SienSing,
Kao JiaHorng,
Su WeiWen,
Lin ChihLin,
Yang HungChih,
Chen PeiJer,
Chen DingShinn,
Liu ChunJen
Publication year - 2013
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.26266
Subject(s) - medicine , ribavirin , hbsag , gastroenterology , hepatocellular carcinoma , hepatitis c virus , peginterferon alfa 2a , hepatitis b virus , hepatitis c , hepatology , immunology , virus
Patients dually infected with hepatitis C virus (HCV)/hepatitis B virus (HBV) have a higher risk of developing advanced liver disease or hepatocellular carcinoma compared with monoinfected patients. Yet, there is a similar rate of sustained virologic response (SVR) after peginterferon alfa‐2a and ribavirin combination therapy in these patients compared with HCV‐monoinfected patients and a high hepatitis B surface antigen (HBsAg) seroclearance rate. The durability of hepatitis C and B clearance in coinfected patients was investigated in a 5‐year follow‐up study. Patients with active HCV genotype 1, both HBV‐coinfected (n = 97) and HBV‐monoinfected (n = 110), underwent 48‐week combination therapy with peginterferon alfa‐2a plus ribavirin. In patients with active HCV genotype 2 or 3, both HBV‐coinfected (n = 64) and monoinfected (n = 50) patients underwent 24‐week combination therapy. A total of 295 (91.9%) patients completed treatment and 24 weeks posttreatment follow‐up; 264 (89.5%) patients agreed to receive additional follow‐up for up to 5 years after the end of treatment. After a median follow‐up of 4.6 ± 1.0 years, six of the 232 patients achieving SVR developed HCV RNA reappearance, including five HCV genotype 1/HBV‐coinfected patients and one HCV genotype 2/3‐monoinfected patient. Subgenomic analysis of the HCV core gene indicated that five patients developed delayed recurrence of HCV infection. Overall, the cumulative recurrence rate of HCV infection was 2.3% (0.4%/year; 95% confidence interval [CI], 0.9%‐5.5%). The cumulative HBsAg seroclearance rate was 30.0% (95% CI, 21.5%‐42.0%); with 33.1% (95% CI, 21.8%‐50.1%) in the 48‐week combination therapy group and 24.3% (95% CI, 13.7%‐42.9%) in the 24‐week therapy group. Conclusion : Peginterferon alfa‐2a and ribavirin therapy provides good HCV SVR durability and a high accumulative HBsAg seroclearance rate in patients who are coinfected with HCV and HBV. (H EPATOLOGY 2013;)