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Direct‐acting antivirals and hepatitis B virus ( HBV ) reactivation in co‐infected HBV / HCV kidney‐transplant recipients
Author(s) -
Pol Stanislas,
Marion Olivier,
ValletPichard Anaïs,
Meritet JeanFrançois,
Sauné Karine,
Alric Laurent,
Kamar Nassim
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12864
Subject(s) - medicine , hepatitis b virus , virology , hepatitis b , kidney transplantation , kidney transplant , antiviral therapy , hepatitis c virus , immunology , virus , kidney , chronic hepatitis
Direct‐acting agents ( DAA s) are highly efficient at treating hepatitis C virus ( HCV ) infections after kidney transplantation. Although drug agencies have recently warned of the risk of hepatitis B virus ( HBV ) reactivation after patients have received DAA s, reports have discrepant results in HB sAg‐positive and HB sAg‐negative patients. We report on 3 cases of HBV reactivation that were detected after achieving a DAA ‐associated sustained virological response in 3 kidney‐transplant recipients initially HB sAg‐negative. In the first case, retrospective virological analysis revealed that HB sAgs had become positive and HBV DNA was detectable before initiating DAA therapy. In the second and third cases, HBV reactivation occurred 2 months and more than 1 year after stopping anti‐ HCV therapy. These cases underline the discrepancies and highlight the need for comprehensive information before making definitive conclusions regarding the causal link between DAA s and HBV reactivation.