Open AccessTHE IMPACT OF OCCULT HEPATITIS B INFECTION ON THE COURSE OF CHRONIC HEPATITIS C TREATMENT WITH DIRECT-ACTING ANTIVIRALS
Author(s) -
Sevda Aghayeva,
Alihuseyn Hidayatov
Publication year - 2022
Publication title -
aktualʹnì problemi sučasnoï medicini: vìsnik ukraïnsʹkoï medičnoï stomatologìčnoï akademì
Language(s) - English
Resource type - Journals
eISSN - 2077-1126
pISSN - 2077-1096
DOI - 10.31718/2077-1096.22.1.4
Subject(s) - medicine , hbsag , occult , hepatitis b , hepatitis , hepatitis b virus , viral hepatitis , immunology , virology , serology , hepatitis c , hepatitis c virus , liver disease , viral load , viral disease , gastroenterology , antibody , virus , pathology , alternative medicine
The prevalence of viral hepatitis B and C in Azerbaijan is 3.2% and 4.3% respectively. The incidence of occult hepatitis B has not been previously studied. The purpose of this study is to assess the prevalence of occult hepatitis B infection among patients with chronic hepatitis C, as well as to assess the impact of occult hepatitis B on the progression of liver disease and to identify the likelihood of viral/clinical reactivation of occult hepatitis B during treatment with direct-acting antiviral drugs. Results. The study included 164 patients with chronic hepatitis C with the absence of overt hepatitis B (HBsAg negative). A specific immunoglobulin to the core antigen of the hepatitis B virus (anti-HBcIgG) was examined and, depending on its serological activity, the patients were divided into 2 groups: 72 anti-HBcIgG-positive and 92 anti-HBcIgG-negative individuals. Hepatitis B Virus DNA was tested in both groups. During the treatment of hepatitis C with direct-acting antiviral drugs, the evidence of viral and clinical reactivation of occult hepatitis B was evaluated. Results. Out of 72 anti-HBc positive patients, 18 (25%) showed detectable viral load. None of the patients had a pre-treatment Hepatitis B Virus DNA level greater than 2000 IU/mL (34-223 IU/mL). Out of 92 anti-HBcIgG negative patients, none had positive Hepatitis B Virus DNA prior to the treatment. In the group of patients with chronic hepatitis C and positive anti-HBcIgG, clinical manifestations and changes in biochemical parameters were more pronounced that in anti-HBcIgG negative group, however, this correlation was not statistically significant. In both groups, there was no 1 log increase in Hepatitis B Virus DNA and ALT during and after the treatment. Conclusions. In Azerbaijan, the presence of anti-HBc IgG was observed in 43% of patients with chronic hepatitis C. In patients who are negative for anti-HBcIgG, 100% had undetectable Hepatitis B Virus DNA. Among those with positive anti-HBcIgG, 25% had low levels of Hepatitis B Virus DNA, which accounted for 10.9% of the total number of patients with chronic hepatitis C. Positive anti-HBcIgG was associated with higher pre-treatment ALT and liver fibrosis score. Treatment with direct-acting antiviral drugs did not cause virological or clinical reactivation of occult hepatitis B in both groups. The presence of OBH did not affect sustained virological response in the treatment of chronic hepatitis C.