Hepatitis B virus reactivation among hepatitis C patients treated with direct-acting antiviral therapies in routine clinical practice |
| |
| Affiliation: | 1. Dipartimento di Scienze Mediche e Chirurgiche & Centro Studi Ricerche sulle Epatiti, Programma Dipartimentale ITEC, Azienda Ospedaliero-Universitaria Policlinico di Sant’Orsola, Bologna, Italy;2. Unità Operativa di Microbiologia e Virologia, Azienda Ospedaliero-Universitaria Sant’Orsola-Malpighi, Bologna, Italy;1. Université de Lorraine, EA 7300 Stress, Immunité, Pathogènes, Vandoeuvre-les-Nancy, F-54505, France;2. Centre Hospitalier Universitaire de Nancy, Laboratoire de Virologie, Vandoeuvre-les-Nancy, F-54511, France;3. Université de Lyon, Unité Inserm UI1052, Lyon, F-69424, France;4. Centre Hospitalier Universitaire de Nancy, Service d’Hépato-gastroentérologie, Vandoeuvre-les-Nancy, F-54511, France;5. Centre Hospitalier Universitaire de Nancy, Service des Maladies Infectieuses et Tropicales, Vandoeuvre-les-Nancy, F-54511, France;1. Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy;2. Clinic of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy;3. Medical Biotechnology Department, University of Siena, Siena, Italy;1. Department of Public Health and Pediatric Sciences, Citoimmunodiagnostics Laboratory, University of Turin, Medical School, 10136 Turin, Italy;2. SC. Pediatric U Regina Margherita Hospital, Piazza Polonia 94, 10126 Turin, Italy;1. Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;2. Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;3. Beijing Youan Hospital, Capital Medical University, Beijing, China;4. Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada;5. Bloodborne Pathogens and Hepatitis Laboratory of the National Microbiology Laboratory, Winnipeg, MB, Canada |
| |
| Abstract: | BackgroundHepatitis B (HBV) reactivation in chronic hepatitis C (CHC) patients treated with IFN-free direct acting antiviral (DAA) therapies has recently emerged as a potential risk. Given the potential burden of this issue, further data are needed to establish its actual clinical impact.ObjectivesThe aim of the present study was to analyze the occurrence of HBV reactivation in a cohort of CHC patient treated with DAAs in routine clinical practice.Study designConsecutive CHC patients with different genotypes, treated with DAA between January 2015 and January 2016 were included in the study. Subjects had been tested for HBsAg and anti-HBc antibodies before antiviral therapy. HBV-DNA levels were examined in anti-HBc positive patients at baseline and 24 weeks after the end of treatment. Post-treatment HBsAg determination was performed in case of HBV-DNA positivity. Serum anti-HBs kinetics was analysed in anti-HBs and anti-HBc positive subjects.ResultsA cohort of 137 consecutive HCV patients treated with IFN-free regimens in routine clinical practice was evaluated. From this cohort, plasma samples of 44 subjects with positive serology for HBV (anti-HBc positive) were tested for HBV-DNA levels at baseline and 24 weeks after the end of treatment. Two of them were HBsAg-positive, while the others had signs of a past HBV exposure (HBsAg-negative ± HBsAb-positive). No reactivation was found in HBcAb-positive and HBsAg-negative subjects. In the two HBsAg-positive, one experienced an increase in HBV-DNA levels of ≥2 log10 IU/mL during treatment. However, the reactivation was without clinical impact and, most important, was followed by HBsAg loss.ConclusionsBased on our experience, a past HBV infection seems not to be a condition predisposing to HBV reactivation. On the contrary, in HBsAg-positive subjects not in suppressive treatment with nucleos(t)ide analogs, regular monitoring of HBV-DNA during and after DAA treatment should be considered. |
| |
| Keywords: | Co-infection Direct-acting antiviral Hepatitis B Hepatitis C Reactivation |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
