TY - JOUR
TI - Hepatitis B and C coinfection in a real-life setting: Viral interactions and treatment issues
AU - Papadopoulos, N.
AU - Papavdi, M.
AU - Pavlidou, A.
AU - Konstantinou, D.
AU - Kranidioti, H.
AU - Kontos, G.
AU - Koskinas, J.
AU - Papatheodoridis, G.V.
AU - Manolakopoulos, S.
AU - Deutsch, M.
JO - Annals of Gastroenterological Surgery
PY - 2018
VL - 31
TODO - 3
SP - 365-370
PB - Hellenic Society of Gastroenterology
SN - null
TODO - 10.20524/aog.2018.0255
TODO - antivirus agent;  direct acting antiviral;  interferon;  ledipasvir plus sofosbuvir;  ribavirin;  tenofovir disoproxil;  unclassified drug, adult;  antiviral therapy;  Article;  clinical article;  controlled study;  female;  hepatitis B;  hepatitis C;  human;  male;  middle aged;  mixed infection;  retrospective study;  superinfection;  sustained virologic response;  treatment outcome;  viral clearance;  virus reactivation;  virus replication
TODO - Background Only limited data concerning hepatitis B (HBV) and C viruses (HCV) coinfection are available. Direct-acting antivirals (DAAs) may be more effective for HCV clearance than interferon (IFN)-based regimens with a risk of HBV reactivation. Methods We retrospectively enrolled 40 HBV/HCV-coinfected patients to evaluate their clinical profile and treatment outcomes. Results Chronic dual infection was present in 25/40 (62.5%) patients, acute HCV superinfection in 5/40 (12.5%) patients and acute HBV superinfection in 10/40 (25%). Twenty-five patients (62.5%) were treated: 16/25 (64%) with IFN, 4/25 (16%) with nucleot(s)ide analogs (NUCs) and 5/25 (20%) with DAAs. Of the 16 patients treated with IFN-based therapy, 6 (37.5%) achieved both sustained virological response (SVR) and HBsAg clearance. Of the 4 patients treated with NUCs, one (25%) achieved both SVR and HBsAg clearance. All five patients treated with DAAs (100%) achieved SVR, while one case of HBV reactivation was recorded. Fifteen of the 40 patients (37.5%) did not receive any treatment. Eight of them (53.5%) presented with acute HBV superinfection: spontaneous HCV clearance was recorded in 5/8 (62.5%), while HBsAg clearance occurred in 6/8 (75%). Three of them (20%) presented with acute HCV superinfection; spontaneous HCV clearance was recorded in one of the three (33.5%). The other four patients (26.5%) presented with dual HBV/HCV infection. Conclusions A significant proportion of patients presented with active HBV replication. Treatment with DAAs seems to be efficacious for HCV eradication. However, clinicians should be aware of HBV reactivation. HBV superinfection may lead to both HBsAg and HCV clearance. © 2018 Hellenic Society of Gastroenterology.
ER -