Interferon-Free Regimens in Hepatitis B Surface Antigen/Anti–Hepatitis C Virus Positive Patients: The Need to Control Hepatitis B Virus Replication to Avoid Hepatitis B Virus Reactivation

Macera, Margherita; Stanzione, Maria; Messina, Vito; D’Adamo, Giuseppe; Sangiovanni, Vincenzo; Mioglioresi, Lucia; Fontanella, Luca; Pascalis, Stefania De; Stornaiuolo, Gianfranca; Lanza, A; Ascione, Tiziana; Sagnelli, E.; Gentile, Ivan; Piai, G.; Gaeta, Giovanni Battista; Coppola, Nicola

doi:10.1016/j.cgh.2017.05.032

Cited by 18 publications

(11 citation statements)

References 8 publications

(5 reference statements)

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“…All patients had been treated with a DAA‐regimen according to the HCV genotype, international guidelines, and local availability by hepatologists in 19 clinical centers in Campania, southern Italy. These centers had cooperated in several clinical investigations using the same clinical approach . At the time of failure, these patients were referred to the laboratory of infectious diseases of the University of Campania Luigi Vanvitelli for a genotype resistance test for RASs in the NS3, NS5A, and NS5B HCV regions.…”

Section: Methodsmentioning

confidence: 99%

Virological patterns of HCV patients with failure to interferon‐free regimens

Starace

Minichini

Pascalis

et al. 2018

Journal of Medical Virology

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The study characterized the virological patterns and the resistance-associated substitutions (RASs) in patients with failure to IFN-free regimens enrolled in the real-life setting. All 87 consecutive HCV patients with failed IFN-free regimens, observed at the laboratory of the University of Campania, were enrolled. All patients had been treated with DAA regimens according to the HCV genotype, international guidelines, and local availability. Sanger sequencing of NS3, NS5A, and NS5B regions was performed at failure by home-made protocols. Of the 87 patients enrolled, 13 (14.9%) showed a misclassified HCV genotype, probably causing DAA failure, 16 had been treated with a sub-optimal DAA regimen, 19 with a simeprevir-based regimen and 39 with an optimal DAA regimen. A major RAS was identified more frequently in the simeprevir regimen group (68.4%) and in the optimal regimen group (74.4%) than in the sub-optimal regimen group (56.3%). The prevalence of RASs in NS3 was similar in the three groups (30.8-57.9%), that in NS5A higher in the optimal regimen group (71.8%) than in the sub-optimal regimen group (12.5%, P < 0.0001) and in the simeprevir regimen group (31.6%, P < 0.0005), and that in NS5B low in all groups (0-25%). RASs in two or more HCV regions were more frequently identified in the optimal regimen group (46.6%) than in the simeprevir-based regimen group (31.6%) and sub-optimal regimen group (18.7%). In our real-life population the prevalence of RASs was high, especially in NS3 and NS5A and in those treated with suitable DAA regimens.

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Section: Methodsmentioning

confidence: 99%

Virological patterns of HCV patients with failure to interferon‐free regimens

Starace

Minichini

Pascalis

et al. 2018

Journal of Medical Virology

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“…Overall, the risk is very low [90][91][92]. However, reactivation of HBV may arise in patients without control of HBV replication by nucleos(t)id analogues, with potentially severe liver damage [93].…”

Section: The Risk Of Hbv Reactivation Associated With Iahbc Patternmentioning

confidence: 99%

Isolated Anti-HBc: Significance and Management

Moretto

Catherine

Estève

et al. 2020

JCM

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Hepatitis B virus (HBV) infection is prevalent worldwide and is associated with dramatic levels of morbidity and mortality. Isolated anti-HBc (IAHBc) is a particular serological pattern that is commonly found in immunocompromised patients. There is ongoing debate regarding the management of patients with IAHBc. Herein, we summarize the current guidelines and the newest evidence. The frequency of IAHBc is variable, with a higher prevalence in some populations, such as persons living with HIV and others immunocompromised patients. The risk of HBV reactivation depends on host factors (including immunosuppression) and viral factors. It is now well established that immunocompromised patients can be classified into three groups for risk according to the type of immunosuppression and/or treatment. In patients at high risk, HBV therapy has to be considered systematically. In patients at moderate risk, the decision is based on the level of HBV DNA (preemptive treatment or monitoring and vaccination). In patients with low risk, HBV vaccination is another possible approach, although further studies are needed to assess the type of preemptive strategy.

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“…A total of 425 patients positive for HBsAg (including the 37 patients from the Egyptian study), and 1900 patients negative for HBsAg but positive for anti‐HBc were used to estimate the pooled risks. Nine studies (10 articles) were from East Asia, 6 from Europe, 1 from USA and 1 from New Zealand . All of these studies included patients on IFN‐free DAAs regimens for 8‐24 weeks.…”

Section: Resultsmentioning

confidence: 99%