Potential risk of HBV reactivation in patients with resolved HBV infection undergoing direct‐acting antiviral treatment for HCV. (29th June 2017)

• Record Type: Journal Article
• Authors: Ogawa, Eiichi; Furusyo, Norihiro; Murata, Masayuki; Toyoda, Kazuhiro; Hayashi, Takeo; Ura, Kazuya
• Is Part Of: Liver international. Volume 38:Number 1(2018)
• Page Start: 76
• Page End: 83
• Publication Date: 2017-06-29
• Subjects: direct‐acting antivirals -- hepatitis B virus reactivation -- hepatitis C virus -- resolved HBV infection -- sofosbuvir; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13496
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background & Aims: Despite a known risk of hepatitis B virus (HBV) reactivation during direct‐acting antiviral (DAA) treatment for patients with hepatitis C virus (HCV)‐HBV coinfection, it remains unclear whether patients with past HBV infection are at risk for reactivation. This study evaluated the risk of HBV reactivation during treatment with sofosbuvir (SOF)‐based regimens, focusing on patients with resolved HBV infection. Methods: This study analyzes the data of 183 consecutive patients treated with SOF‐based regimens. From these patients, 63 with resolved HBV infection (negative for hepatitis B surface antigen [HBsAg] and undetectable HBV DNA but positive for hepatitis B core antibody) were eligible for this study. HBV reactivation was defined as a quantifiable HBV DNA level >20 IU/mL. Results: Among the patients antibody to HBsAg (anti‐HBs) positive (10‐500 mIU/mL) (n = 30), the titre of anti‐HBs was significantly decreased with time, as shown by the results of repeated‐measures analysis of variance ( P = .0029). Overall, four patients (6.3%) with resolved HBV infection came to have detectable HBV DNA during treatment, including one who had HBV reactivation at week 4 (HBV DNA 80 IU/mL). However, none developed hepatic failure. Among four patients who had detectable HBV DNA during treatment, all were negative or had very low‐titre (<20 mIU/mL) anti‐HBs at baseline. Conclusions: The titre of anti‐HBs was significantly decreased from the early stage of DAA treatment. Chronic hepatitis C patients with resolved HBV infection and negative or very low‐titre anti‐HBs at baseline are at risk for having detectable HBV DNA transiently during treatment.