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

Abstract

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.

HCV resistance compartmentalization within tumoral and non‐tumoral liver in transplanted patients with hepatocellular carcinoma

“…A mutual influence between HBV and HCV replication has already been found. [8][9][10][45][46][47] Higher HCV activity in HBV-coinfected patients with a related HCV suppressing effect on HBV replication has also been demonstrated. 9,45,[48][49][50] In addition, the successful elimination of HCV resulted in some cases in an HBV 12,49,51 Although the restricted availability of samples/patients greatly limited a deeper investigation into HBV, to date, this is the first study that has shown a potential impact of HBV co-infection also on HCV variability and/or compartmentalization.…”

“…To date, HBV-HCV chronic coinfection is estimated to be between 0.7% and 17.8%, depending on geographical regions and study populations. 8,9 The interplay between the two infections has a high association with more aggressive cirrhosis and the establishment of HCC. [9][10][11] Moreover, HBV reactivation in patients treated for HCV with directacting agents (DAAs) has recently emerged as an important clinical consideration.…”

Hepatitis B virus and hepatitis C virus co-infection among outdoor patients and indoor patients of tertiary care institute, Bathinda, Punjab, India

“…16 Hepatitis B virus (HBV) and hepatitis C virus (HCV) have several important similarities including worldwide distribution, hepatotropism, similar modes of transmission and the ability to induce chronic infection that may lead to liver cirrhosis and hepatocellular carcinoma. 17 Acute HBV/HCV co-infection is more prevalent in patients who inject drugs. 18 Co-infected patients represent a diverse group with various patterns of viral replication and great variations of immune profile.…”

Validation of a cell-based colorimetric reporter gene assay for the evaluation of Type I Interferons

“…Type I Interferons (IFN-I) are cytokines composed mainly by IFN-α and β [ 1 ], which have important roles in innate and adaptive immune responses with effects over a broad range of mammalian cells [ 2 , 3 ]. The type I IFN display broad biological activity, including control of cell proliferation, induction of genes responsible for protecting cells against the effects of viral infection, regulation of the differentiation state of immune cells and modulation of their function, accordingly these cytokines have been used in the treatment of viral and proliferative disease [ [4] , [5] , [6] , [7] , [8] , [9] ].…”