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Clin Gastroenterol Hepatol. 2017 Jan;15(1):132-136. doi: 10.1016/j.cgh.2016.06.023. Epub 2016 Jul 5.

Hepatitis due to Reactivation of Hepatitis B Virus in Endemic Areas Among Patients With Hepatitis C Treated With Direct-acting Antiviral Agents.

Author information

1
Division of Gastroenterology and Hepatology, Humanity and Health Medical Centre, Hong Kong SAR, China; State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
2
Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China; Liver Failure Treatment and Research Centre, 302 Hospital, Beijing, China.
3
Division of Gastroenterology and Hepatology, Humanity and Health Medical Centre, Hong Kong SAR, China.
4
Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China.
5
State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
6
Hong Kong Molecular Pathology Diagnostic Centre, Hong Kong SAR, China.
7
Institute of Translational Hepatology, 302 Hospital, Beijing, China.
8
Division of Gastroenterology and Hepatology, Humanity and Health Medical Centre, Hong Kong SAR, China; Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China; Institute of Translational Hepatology, 302 Hospital, Beijing, China. Electronic address: gkklau@netvigator.com.

Abstract

Hepatitis due to reactivation of hepatitis B virus (HBV) has been reported in patients treated with direct-acting antiviral (DAA) agents for chronic hepatitis C virus infection. We performed an observational study to determine the incidence of and factors associated with hepatitis in 327 patients receiving pan-oral DAA agents for HCV infections in areas endemic for HBV in China. Ten patients were positive for hepatitis B surface antigen (HBsAg), and 124 patients had occult HBV infection. HBV reactivation was determined by measuring HBV DNA and HBsAg status in serial serum samples collected every 2 weeks during DAA treatment and then every 4 weeks after treatment until week 12. In the total study population, 10 patients (3.1%) had hepatitis; 3 cases were associated with HBV reactivation (1 case not in the icteric phase, 1 case in the icteric phase, and 1 case with liver failure) and 7 from other causes. Testing positive for HBsAg before DAA treatment was a strong risk factor for developing hepatitis during treatment (hazard ratio, 15.0; P < .001).

KEYWORDS:

Coinfection; Prognostic Factor; Risk Factor; Therapy

Comment in

PMID:
27392759
DOI:
10.1016/j.cgh.2016.06.023
[Indexed for MEDLINE]

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