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Potential risk of HBV reactivation in patients with resolved HBV infection undergoing direct‐acting antiviral treatment for HCV
Author(s) -
Ogawa Eiichi,
Furusyo Norihiro,
Murata Masayuki,
Toyoda Kazuhiro,
Hayashi Takeo,
Ura Kazuya
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13496
Subject(s) - medicine , hbsag , hepatitis b virus , coinfection , virology , titer , hepatitis b , antibody , immunology , orthohepadnavirus , virus , gastroenterology
Background & Aims Despite a known risk of hepatitis B virus ( HBV ) reactivation during direct‐acting antiviral ( DAA ) treatment for patients with hepatitis C virus ( HCV )‐ HBV coinfection, it remains unclear whether patients with past HBV infection are at risk for reactivation. This study evaluated the risk of HBV reactivation during treatment with sofosbuvir ( SOF )‐based regimens, focusing on patients with resolved HBV infection. Methods This study analyzes the data of 183 consecutive patients treated with SOF ‐based regimens. From these patients, 63 with resolved HBV infection (negative for hepatitis B surface antigen [ HB sAg] and undetectable HBV DNA but positive for hepatitis B core antibody) were eligible for this study. HBV reactivation was defined as a quantifiable HBV DNA level >20 IU / mL . Results Among the patients antibody to HB sAg (anti‐ HB s) positive (10‐500 mIU / mL ) (n = 30), the titre of anti‐ HB s was significantly decreased with time, as shown by the results of repeated‐measures analysis of variance ( P = .0029). Overall, four patients (6.3%) with resolved HBV infection came to have detectable HBV DNA during treatment, including one who had HBV reactivation at week 4 ( HBV DNA 80 IU / mL ). However, none developed hepatic failure. Among four patients who had detectable HBV DNA during treatment, all were negative or had very low‐titre (<20 mIU / mL ) anti‐ HB s at baseline. Conclusions The titre of anti‐ HB s was significantly decreased from the early stage of DAA treatment. Chronic hepatitis C patients with resolved HBV infection and negative or very low‐titre anti‐ HB s at baseline are at risk for having detectable HBV DNA transiently during treatment.