HealthDay News — For patients with chronic hepatitis C (CHC) treated with direct-acting antivirals (DAAs), hepatitis B virus (HBV) reactivation may occur in those with current HBV infection, according to a study published online February 23 in the Journal of Gastroenterology and Hepatology.

Ming-Lun Yeh, MD, from Kaohsiung Medical University in Taiwan, and colleagues examined the risk of HBV reactivation during DAA therapy in patients with CHC. Data were included for 57 patients with past HBV infection (negative hepatitis B surface antigen [HBsAg] and positive hepatitis B core antibody) and seven patients with current HBV infection (positive HBsAg). Serum HBV and hepatitis C virus (HCV) were measured regularly. 

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The researchers found that the overall rate of sustained virological response at 12 weeks was 96.9%; two patients, including one with positive HBsAg, had HCV relapse. Among patients with a past HBV infection there were no episodes of HBV virological reactivation. HBV virological reactivation was seen in four of the seven patients with a current HBV infection (57.1%). One patient with pre-treatment detectable HBV DNA had clinical reactivation of HBV; the patient recovered after administration of entecavir. Low level HBV DNA reappeared without clinical reactivation for the other three patients with HBV virological reactivation.

“For CHC patients with current HBV infection, the risk of HBV reactivation was present, and monitoring the HBV DNA level during therapy is warranted,” the authors write.

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