Premium
Hepatitis B reactivation in patients with chronic hepatitis C undergoing anti‐viral therapy with an interferon‐free regimen
Author(s) -
Londoño M.C.,
Lens S.,
Mariño Z.,
Bonacci M.,
Ariza X.,
Broquetas T.,
Pla A.,
Bartres C.,
Adriani M. V.,
RodríguezTajes S.,
Costa J.,
Carrión J. A.,
PérezdelPulgar S.,
Forns X.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13985
Subject(s) - medicine , discontinuation , regimen , gastroenterology , hepatitis b virus , viral load , hbsag , hepatitis b , viral hepatitis , hepatology , virology , immunology , virus
Summary Background A few cases of hepatitis B virus ( HBV ) reactivation during anti‐viral therapy against hepatitis C ( HCV ) have been reported. However, the information regarding the real impact of this phenomenon is scarce. Aim To evaluate the risk of HBV reactivation during anti‐viral therapy against HCV with an interferon‐free regimen with direct‐acting anti‐virals ( DAA s). Methods Observational and prospective study of 352 patients receiving DAA s therapy between September 2015 and May 2016. HBV ‐ DNA and ALT levels were monitored at baseline, at week 4 of anti‐viral therapy, at end of treatment and 12 weeks after treatment discontinuation in patients with HBV surface antigen ( HB sAg) positive or HBV core antibody (anti‐ HB c) positive before starting anti‐viral therapy. Results Ten (2.8%) and 64 (18%) patients were HB sAg and anti‐ HB c positive at baseline, respectively. Five (50%) of 10 HB sAg positive and one (1.6%) of 64 anti‐ HB c positive patients presented HBV virological reactivation (>1log increase in HBV ‐ DNA levels). None of these patients presented clinical reactivation (increase in ALT levels). Conclusions HBV virological reactivation is frequent in HB sAg+ patients receiving anti‐viral therapy against HCV . However, HBV ‐ DNA elevations were modest (<20 000 IU /mL) and without clinical impact (no ALT elevation).