Risk of hepatitis B virus reactivation in hepatitis B virus + hepatitis C virus‐co‐infected patients with compensated liver cirrhosis treated with ombitasvir, paritaprevir/r + dasabuvir + ribavirin

Abstract

Hepatitis B virus may reactivate in patients with chronic hepatitis C treated with direct-acting antivirals. The aim of this study was to investigate the risk of hepatitis B virus (HBV) reactivation in HBV + hepatitis C virus (HCV)-co-infected patients with compensated liver cirrhosis treated with paritaprevir/ombitasvir/ritonavir, dasabuvir with ribavirin. We reviewed prospectively gathered data from a national cohort of 2070 hepatitis C virus patients with compensated liver cirrhosis who received reimbursed paritaprevir/ombitasvir/r, dasabuvir with ribavirin for 12 weeks from the Romanian National Health Agency during 2015-2016. Twenty-five patients in this cohort were HBs antigen positive (1.2%); 15 untreated with nucleotide analogues agreed to enter the study. These patients were followed up: ALT monthly, serology for HBV and DNA viral load at baseline, EOT and SVR at 12 weeks. Hepatitis B virus (HBV)-co-infected patients were all genotype 1b and 52% females, with a median age of 60 years (51 ÷ 74); 76% were pretreated with peginterferon + ribavirin; 72% were with severe necroinflammatory activity on FibroMax assessment; 40% presented comorbidities; and all were HBe antigen negative. Hepatitis C virus (HCV) SVR response rate was 100%. Hepatitis B virus (HBV)-DNA viral load was undetectable in 7/15 (47%) before therapy, and for the other 8 patients, it varied between below 20 and 867 IU/mL. Five patients (33%) presented virological reactivation (>2 log increase in HBV-DNA levels) during therapy. One patient presented with hepatitis associated with HBV reactivation, and two started anti-HBV therapy with entecavir. Hepatitis B virus (HBV) virological reactivation was present in 33% in our patients. Generally, HBV-DNA elevations were mild (<20 000 IU/mL); however, we report one case of hepatitis associated with HBV reactivation.

Statin Use and the Risk of Hepatocellular Carcinoma: A Meta-Analysis of Observational Studies

“…HCC often develops in patients with chronic liver disease [4]. Chronic liver diseases, such as hepatitis C virus (HCV), hepatitis B virus, nonalcoholic fatty liver disease, autoimmune liver disease, and alcoholic liver disease lead to liver cirrhosis and eventually to HCC [5][6][7]. Liver cirrhosis is present in approximately 98% of HCC patients [8].…”

Efficacy and Safety of Ledispavir/Sofosbuvir with or without Ribavirin in patients with Decompensated Liver Cirrhosis and Hepatitis C Infection: a Cohort Study

“…Hepatitis C virus (HCV) is an epidemic problem worldwide, a f f e c t i n g a p p r o x i m a t e l y 71 million people [1,2]. In R o m a n i a , t h e e s t i m a t e d prevalence of chronic HCV according to data published in 2010 was approximately 4% [3], but it is decreasing now due to reimbursed direct directantiviral agents (DAAs), received by approximately 35,000 patients with more than a 96% sustained virologic response (SVR) rate [4][5][6]. In Romania, genotype 1b is almost exclusively present among the infected patients [7].…”

Risk of hepatitis B virus reactivation with direct‐acting antivirals against hepatitis C virus: A cohort study from Egypt and meta‐analysis of published data

“…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.…”