https://scholars.lib.ntu.edu.tw/handle/123456789/638378
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.author | CHUN-JEN LIU | en_US |
dc.contributor.author | JIA-HORNG KAO | en_US |
dc.date.accessioned | 2024-01-10T07:35:10Z | - |
dc.date.available | 2024-01-10T07:35:10Z | - |
dc.date.issued | 2020-01-01 | - |
dc.identifier.isbn | 9781119533481 | - |
dc.identifier.uri | https://scholars.lib.ntu.edu.tw/handle/123456789/638378 | - |
dc.description.abstract | We may encounter patients with hepatitis C virus (HCV) and hepatitis B virus (HBV) coinfection in HBV or HCV endemic areas. Coinfection can also be found in populations at risk for parenteral transmission. Community cohort and hospital-based case-controlled studies have demonstrated a higher risk of liver disease progression in those with HCV/HBV coinfection in comparison with HBV or HCV mono-infected patients. Earlier trials supported the value of combination therapy of peginterferon alfa-2a or -2b and ribavirin for co-infected patients with positive HCV RNA. Further, HBsAg seroclearance can be achieved in about 30% of the co-infected patients within 5 years after initiating peginterferon-based therapy. However, there still exist unmet needs for those coinfected patients who are unable to tolerate or are ineligible for peginterferon-based therapy. The advent of new direct-acting antivirals (DAAs)-based anti-HCV therapy increases the rate of HCV clearance and fills the unmet gap for such patients. A recent multicenter trial in Taiwan demonstrated that the HCV sustained virologic response rate was high (100%) in coinfected patients with genotype 1 or 2 infection. Notably, DAA would not have any activity against HBV infection; thus may therefore HBV reactivation and related hepatitis activity while on HCV therapy or after cure of HCV as warned by the US FDA. Our trial data demonstrated that ~70% of the subjects experienced HBV reactivation event within 48 weeks after start of DAA therapy. Management of HBV reactivation including prevention of HBV reactivation post HCV cure is a clinical unresolved issue that needs to be addressed by further clinical trials. Overall, major advances in the treatment of HCV/HBV coinfection have been made over the past 15 years. Prevention or preemptive management of HBV reactivation would need further evaluation through rigorously done clinical trials. | en_US |
dc.relation.ispartof | Clinical Dilemmas in Viral Liver Disease, Second Edition | en_US |
dc.subject | Coinfection | direct-acting antivirals | hepatitis B virus | hepatitis C virus | pegylated interferon | en_US |
dc.title | Hepatitis C and hepatitis B coinfection | en_US |
dc.type | book chapter | en_US |
dc.identifier.doi | 10.1002/9781119533481.ch32 | - |
dc.identifier.scopus | 2-s2.0-85137413853 | - |
dc.identifier.url | https://api.elsevier.com/content/abstract/scopus_id/85137413853 | - |
dc.relation.pageend | 188 | en_US |
item.fulltext | no fulltext | - |
item.cerifentitytype | Publications | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.grantfulltext | none | - |
item.openairetype | book chapter | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.dept | Clinical Medicine | - |
crisitem.author.dept | Internal Medicine-NTUH | - |
crisitem.author.orcid | 0000-0002-6202-0993 | - |
crisitem.author.orcid | 0000-0002-2442-7952 | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
crisitem.author.parentorg | College of Medicine | - |
crisitem.author.parentorg | National Taiwan University Hospital | - |
顯示於: | 臨床醫學研究所 |
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