Hepatitis B reactivation in hepatitis B and C coinfected patients treated with antiviral agents: A systematic review and meta‐analysis

Chen, Guofeng; Wang, Cheng; Chen, Jing; Ji, Dong; Wang, Yudong; Wu, Vanessa; Karlberg, Johan; Lau, George

doi:10.1002/hep.29109

Cited by 137 publications

(129 citation statements)

References 46 publications

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“…In addition, hepatitis due to HBV reactivation was more frequent in the case of DAA-based therapies. Virus reactivation also occurred, although less frequently, in hepatitis C patients with occult HBV infection treated with DAAs (Chen et al 2017). Testing for evidence of HBV infection is recommended in all HCV-infected patients before initiating DAA treatment.…”

Section: Clinical Consequences Of Immune Reconstruction During Treatmmentioning

confidence: 99%

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

Urbanowicz

Zagożdżon

Ciszek

2018

Arch. Immunol. Ther. Exp.

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The treatment of patients with chronic hepatitis C virus (HCV) infection has changed tremendously over the past 2 years, with an increasing variety of all-oral direct-acting antiviral (DAA) treatment regimens available for different HCV genotypes and distinct clinical settings. These treatments have significantly improved safety in patients with advanced liver disease compared with interferon (IFN)-based regimens. HCV modifies the human immune system to escape immunosurveillance via several mechanisms. One of the basic mechanisms of HCV is the ability to “switch” the immune response by reducing the activity of cells responsible for the elimination of virus-infected cells. IFN-free DAA treatment regimens provide a unique opportunity to assess the effect of HCV elimination on the immune system. Abrupt changes in the immune system can in some cases be responsible for two alarming processes: viral reactivation in patients with chronic hepatitis B and recurrence of hepatocellular carcinoma in patients with previous successful cancer treatment.

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Section: Clinical Consequences Of Immune Reconstruction During Treatmmentioning

confidence: 99%

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

Urbanowicz

Zagożdżon

Ciszek

2018

Arch. Immunol. Ther. Exp.

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“…From 377 HBV/HCV‐coinfected patients, Belperio and colleagues reported HBV reactivation in eight patients (2%) 25. Similarly, in a large systematic analysis of 1185 patients, the cumulative incidence of HBV reactivation was 14.1% in HBsAg‐positive patients treated with DAAs 26.…”

Section: Resultsmentioning

confidence: 97%

What do clinicians need to watch for with direct‐acting antiviral therapy?

Aghemo

Piroth

2018

J Intern AIDS Soc

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IntroductionThe introduction of drugs targeting the virus replication cycle has revolutionized treatment of chronic hepatitis C virus. These drugs, called direct‐acting antivirals, have brought about extremely high rates of virological cure and have increased the number of patients who can receive treatment due to the lack of absolute contraindications. A combination of different classes of direct‐acting antivirals is the current standard of care. Although treatment administration and monitoring has been simplified in recent years, it is still relatively complex and mostly in the hands of specialists. Several factors must be assessed before starting treatment to maximize efficacy and minimize side effects of treatment. In this review, we describe the factors that impact on the efficacy and safety of antiviral treatment for hepatitis C and provide clear recommendations for clinicians prescribing direct‐acting antivirals.MethodsWe reviewed literature to define best practice, based on factors associated with treatment efficacy and safety data to recommend treatment options, baseline and on‐treatment assessments. The review included searches in PubMed, and the abstracts presented at the International Liver Congress TM and The Liver Meeting TM between January 2013 and September 2017.ResultsClinical features that must be assessed before starting treatment include virological factors, such as hepatitis C virus genotype, HIV and hepatitis B coinfection and host factors, such as concomitant medications, liver disease stage and renal function.ConclusionsPatients who start antiviral treatment for chronic hepatitis C require a thorough clinical evaluation. There is a need for assessing factors that impact on the treatment schedule and duration or affect the pharmacokinetics of direct‐acting antivirals.

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“…HBV DNA: 8.9 × 10 4 copies/ml (from a special lab) [19]. This phenomenon is becoming more common; a recent meta-analysis including data through September 2016 cited 7 studies with evidence of DAA induced reactivation of HBV [20]. The aforementioned meta-analysis conducted by Chen, et al compared HBV reactivation in patients treated with DAAs to those treated with interferon-based therapy, as the patient in this case, and it found that rates of reactivation are similar despite choice of treatment, however, time to overt HBV infection after achieving sustained virologic response was shorter in those who received DAAs [20].…”

Section: Discussionmentioning

confidence: 99%

Reactivation of Chronic HBV Infection Leading to HCC following Treatment of HCV with an Interferon-Based Regimen

Divya¹,

Kistler²,

David³

et al. 2018

J Clin Gastroenterol Treat

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Hepatitis B reactivation in hepatitis B and C coinfected patients treated with antiviral agents: A systematic review and meta‐analysis

Cited by 137 publications

References 46 publications

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

What do clinicians need to watch for with direct‐acting antiviral therapy?

Reactivation of Chronic HBV Infection Leading to HCC following Treatment of HCV with an Interferon-Based Regimen

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