Risks for Hepatitis B Reactivation with Newer Hep C Treatments Detailed

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PHYSICIAN'S FIRST WATCH

January 22, 2018
Risks for Hepatitis B Reactivation with Newer Hep C Treatments Detailed
By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

About a quarter of patients with chronic hepatitis B infection experience reactivation of the virus when they receive direct-acting antivirals (DAAs) for hepatitis C infection, according to a meta-analysis in the Lancet Gastroenterology and Hepatology.

The analysis included 17 observational studies among over 1600 patients with chronic or resolved HBV infection who were treated with interferon-free DAA regimens (e.g., ledipasvir plus sofosbuvir) for chronic HCV. Some 24% of those with chronic HBV infection — versus 1.4% of those with resolved infection — had HBV reactivation during treatment. Additionally, 9% of those with chronic HBV experienced hepatitis related to HBV reactivation, versus none of those with resolved HBV.

The authors say their findings "support the use of antiviral prophylaxis in patients with chronic HBV and HCV coinfection" being treated with DAAs. They add, "By contrast, patients with resolved HBV infection might only require close [alanine aminotransferase] or HBV DNA monitoring, or both."

LINK(S): Lancet Gastroenterology and Hepatology article (Free abstract)

Background: Recent NEJM Journal Watch Infectious Diseases coverage of HBV reactivation during HCV treatment (Free)