Virologic and histologic characterisation of dual hepatitis B and C co-infection in Egyptian patients

Mekky, Mohamed A.; Nasr, A. M. Seif El; Saleh, Medhat A.; Wasif, Nasr K.; Khalaf, Marwa; Aboalam, Hany; Haredy, Mahmoud

doi:10.1016/j.ajg.2013.11.003

Cited by 18 publications

(12 citation statements)

References 16 publications

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“…Asian ethnicity, younger age, persons who inject drugs and higher number of lifetime sexual partners were all associated risk factors for HCV/HBV coinfection. In the Middle East, small studies from Egypt and Turkey have reported that the prevalence of HBV coinfection in HCV positive individuals was 0.7% and 2.6%, respectively (28, 29). …”

Section: Prevalence Of Hcv and Hbv Infectionmentioning

confidence: 99%

Hepatitis B reactivation during or after direct acting antiviral therapy – implication for susceptible individuals

Holmes

Chung

2017

Expert Opinion on Drug Safety

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Introduction The FDA issued a warning following 24 cases of HBV reactivation during DAA therapy for HCV, including individuals with inactive, occult and past HBV infection. Clinical presentations ranged from asymptomatic fluctuations in HBV DNA to fulminant hepatic failure, liver transplantation and death. The mechanism is unknown. Areas covered HCV/HBV coinfection is common, particularly in regions endemic for HBV. HCV and HBV utilize host factors to support replication; both viruses evade/impair host immunity. Clinical presentations of HBV reactivation during DAAs are summarized. Other causes of HBV reactivation are revisited and recent data regarding HBV reactivation are presented. Expert opinion HBV reactivation during DAAs for HCV occurs, with life-threatening consequences in some individuals. The risk of HBV reactivation is observed in all HBV stages. The rapid removal of HCV likely alters and liberates host-viral +/− viral-viral interactions that lead to increased HBV replication. As immune reconstitution occurs with HCV removal, host recognition of HBV DNA likely ensues followed by vigorous host immune responses leading to liver injury (HBV flare). These cases highlight the importance of HBV testing prior to initiating DAA therapy, the need for close monitoring of HBV during therapy and timely administration of anti-HBV therapy to prevent serious sequelae.

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Section: Prevalence Of Hcv and Hbv Infectionmentioning

confidence: 99%

Hepatitis B reactivation during or after direct acting antiviral therapy – implication for susceptible individuals

Holmes

Chung

2017

Expert Opinion on Drug Safety

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“…On the other hand, HBV/HCV-coinfected patients represent a group with significant heterogeneity regarding clinical features, impact on the severity of liver disease and therapeutic options. While liver disease activity and progression are generally more severe in the presence of double infection, the host’s immune response plays an important role in coordinating each single viral replication and the viral interference, usually leading to a predominance of one of the two viruses [ 1 - 2 , 4 - 5 ]. Thus, several clinical scenarios have been described in the natural course of this dual infection [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B and C coinfection in a real-life setting: viral interactions and treatment issues

Papadopoulos¹,

Papavdi

Pavlidou³

et al. 2018

aog

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Background:Only limited data concerning hepatitis B (HBV) and C viruses (HCV) coinfection are available. Direct-acting antivirals (DAAs) may be more effective for HCV clearance than interferon (IFN)-based regimens with a risk of HBV reactivation.Methods:We retrospectively enrolled 40 HBV/HCV-coinfected patients to evaluate their clinical profile and treatment outcomes.Results:Chronic dual infection was present in 25/40 (62.5%) patients, acute HCV superinfection in 5/40 (12.5%) patients and acute HBV superinfection in 10/40 (25%). Twenty-five patients (62.5%) were treated: 16/25 (64%) with IFN, 4/25 (16%) with nucleot(s)ide analogs (NUCs) and 5/25 (20%) with DAAs. Of the 16 patients treated with IFN-based therapy, 6 (37.5%) achieved both sustained virological response (SVR) and HBsAg clearance. Of the 4 patients treated with NUCs, one (25%) achieved both SVR and HBsAg clearance. All five patients treated with DAAs (100%) achieved SVR, while one case of HBV reactivation was recorded. Fifteen of the 40 patients (37.5%) did not receive any treatment. Eight of them (53.5%) presented with acute HBV superinfection: spontaneous HCV clearance was recorded in 5/8 (62.5%), while HBsAg clearance occurred in 6/8 (75%). Three of them (20%) presented with acute HCV superinfection; spontaneous HCV clearance was recorded in one of the three (33.5%). The other four patients (26.5%) presented with dual HBV/HCV infection.Conclusions:A significant proportion of patients presented with active HBV replication. Treatment with DAAs seems to be efficacious for HCV eradication. However, clinicians should be aware of HBV reactivation. HBV superinfection may lead to both HBsAg and HCV clearance.

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“…The prevalence of hepatitis C virus infection of 6.4% obtained in this report is comparable to the 6.2% from a study [12] carried out much earlier among patients attending Aminu Kano Teaching Hospital, Kano (North-West Nigeria). We report a higher hep- has been reported [22][23][24] and may be explained by the shared mode of transmission of both infections. There have been conflicting reports concerning the impact of dual infection with hepatitis B and C on liver disease progression and risk of developing hepatocellular carcinoma compared to mono infection [22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 42%

“…We report a higher hep- has been reported [22][23][24] and may be explained by the shared mode of transmission of both infections. There have been conflicting reports concerning the impact of dual infection with hepatitis B and C on liver disease progression and risk of developing hepatocellular carcinoma compared to mono infection [22][23][24][25][26]. Increased morbidity in HCV/HBV co-infection observed by some researchers [25,26] has been attributed to viral interaction, individual immunological responses and challenges resulting from the treatment of hepatitis C such as reactivation of hepatitis B infection [27,28].…”

Section: Discussionmentioning

confidence: 42%

Hepatitis C in Adults and Children: A Cross-Sectional Review from a Tertiary Hospital, Northeast Nigeria during the Period 2008-2015

Warnow¹,

Ajani²,

JaloIliya³

et al. 2019

J Infect Dis Epidemiol

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Background: HCV is a leading cause of liver cirrhosis, hepatocellular carcinoma and liver failure related deaths among children, adolescents and adults worldwide. Sub-Saharan Africa suffers disproportionately from lack of access to both screening for HCV and treatment services with a resultant high rate of chronic hepatitis C related morbidity and mortality. Nigeria is considered among countries with high Hepatitis C burden and the national prevalence average in 2013 was estimated to be 2.2%. Routine screening for hepatitis C antibody in the country is however sub-optimal. The present study sought to determine the prevalence of hepatitis C antibody in adults and children. Methods: This was a cross-sectional analysis of adults and children tested for Hepatitis C at the Federal Teaching Hospital, Gombe; northeast Nigeria from January 2008 to December 2015. We consecutively reviewed results of Hepatitis C antibody tests performed using HCV ACON rapid immunoassay. Variables including age; sex, year test was performed and hepatitis C antibody status were analysed. Results: 6874 individuals tested aged 1-98 years; male: female ratio 1.4:1. HCV antibody was positive in 473 (6.9%). HCV antibody sero-positivity was associated with increasing age and was highest (18.0%) above 65 years. (p < 0.001) 282 (59.6%) with HCV antibody also tested for HBsAg. Dual seropositivity with HBsAg and HCV antibody was significantly higher among males (p < 0.001). Conclusion: Hepatitis C prevalence is high and increased with age to peak in the elderly. Dual HBV/HCV infection is highest in males.

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Virologic and histologic characterisation of dual hepatitis B and C co-infection in Egyptian patients

Cited by 18 publications

References 16 publications

Hepatitis B reactivation during or after direct acting antiviral therapy – implication for susceptible individuals

Hepatitis B reactivation during or after direct acting antiviral therapy – implication for susceptible individuals

Hepatitis B and C coinfection in a real-life setting: viral interactions and treatment issues

Hepatitis C in Adults and Children: A Cross-Sectional Review from a Tertiary Hospital, Northeast Nigeria during the Period 2008-2015

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