Hepatitis B virus reactivation in patients receiving interferon-free direct-acting antiviral agents for chronic hepatitis C virus infection
Journal
Open Forum Infectious Diseases
Journal Volume
4
Journal Issue
1
Date Issued
2017
Abstract
Background. Little is known about the risk of hepatitis B virus (HBV) reactivation in patients receiving interferon (IFN)-free direct-acting antiviral agents (DAAs) for hepatitis C virus (HCV). Methods. Patients who were seropositive for HBV core antibody and who received IFN-free DAAs for HCV were enrolled. Hepatitis B virus reactivation was defined as reappearance of serum HBV deoxyribonucleic acid (DNA) ?100 IU/mL in patients with baseline undetectable viral load, or ?2 log10 IU/mL increase of HBV DNA in patients with baseline detectable viral load. Hepatitis B virus-related alanine aminotransferase (ALT) flare was defined as ALT ?5 times upper limit of normal or ?2 times of the baseline level. Hepatitis B virus-related hepatic decompensation was defined as presence of jaundice, coagulopathy, hepatic encephalopathy, or ascites. Results. Compared with no HBV reactivation in 81 HBV surface antigen (HBsAg)-negative patients, 2 of 12 HBsAg-positive patients had HBV reactivation (0% [confidence interval (95% CI), 0%-4.5%] vs 16.7% [95% CI, 4.7%-44.8%], P = .015). No patients had ALT flare or hepatic decompensation. Baseline HBsAg level at a cutoff value of 500 IU/mL was associated with HBV reactivation in HBsAg-positive patients. There was no HBsAg seroreversion in HBsAg-negative patients. Conclusions. Hepatitis B virus reactivation is limited to HBsAg-positive patients receiving IFN-free DAAs for HCV. Higher baseline HBsAg levels are associated with HBV reactivation. The risk of ALT flares or hepatic decompensation is low in these patients. ? The Authors 2017.
SDGs
Other Subjects
alanine aminotransferase; antivirus agent; bilirubin; dasabuvir plus ombitasvir plus paritaprevir plus ritonavir; hemoglobin; hepatitis B surface antigen; ledipasvir; peginterferon; ribavirin; sofosbuvir; virus DNA; virus RNA; adult; aged; antiviral therapy; Article; bacterial peritonitis; chronic hepatitis C; cohort analysis; decompensated liver cirrhosis; female; Hepatitis B virus; Hepatitis C virus; Hepatitis C virus genotype 2; Hepatitis C virus subtype 1a; Hepatitis C virus subtype 1b; human; major clinical study; male; priority journal; prospective study; risk assessment; viremia; virus load; virus reactivation
Publisher
Oxford University Press
Type
journal article