Hepatitis B virus reactivation during direct-acting antiviral therapy for hepatitis C: a systematic review and meta-analysis

Mücke, Marcus M.; Backus, Lisa I.; Mücke, Victoria T.; Coppola, Nicola; Preda, Carmen Monica; Yeh, Ming‐Lun; Tang, Lydia; Belperio, Pamela S.; Wilson, Eleanor; Yu, Ming‐Lung; Zeuzem, Stefan; Herrmann, Eva; Vermehren, Johannes

doi:10.1016/s2468-1253(18)30002-5

Cited by 138 publications

(123 citation statements)

References 38 publications

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“…Patients receiving SOF/RBV had higher rates of fatigue, pruritus, and hemoglobin levels of < 10 g/dL than those receiving SOF/DCV or SOF/LDV, which were probably related to the use of RBV. Among the eight patients with HBV coinfection, the risks of HBV reactivation and the HBV‐related hepatitis following DAA treatment were 37.5% and 0%, which were comparable with the report from a meta‐analysis enrolling 242 HBV‐coinfected patients . Although there were no apparent clinical events related to HBV reactivation in our study, prudential surveillance of HBV viral load is still recommended to manage potential complications at the earliest stage.…”

Section: Discussionsupporting

confidence: 85%

Sofosbuvir‐based direct acting antiviral therapies for patients with hepatitis C virus genotype 2 infection

Liu

et al. 2019

J of Gastro and Hepatol

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Background and Aim Data regarding the comparative effectiveness and safety of sofosbuvir (SOF) in combination with ribavirin (RBV), daclatasvir (DCV), or ledipasvir (LDV) for hepatitis C virus genotype 2 (HCV‐2) patients were limited. We aimed to evaluate the performance of these regimens in Taiwan. Methods One hundred eighty‐seven HCV‐2 patients with compensated liver diseases receiving SOF in combination with RBV (n = 82), DCV (n = 66), or LDV (n = 39) for 12 weeks were retrospectively enrolled. The effectiveness was determined by sustained virologic response 12 weeks off therapy (SVR12). The patient characteristics potentially related to SVR12 were compared. The safety profiles and laboratory abnormalities were assessed. Results The SVR12 rates were 93.9% (95% confidence interval [CI]: 86.5–97.4%), 98.5% (95% CI: 91.9–99.7%), and 100% (95% CI: 91.0–100%) in patients receiving SOF combined with RBV, DCV, and LDV, respectively. All patients tolerated treatment well. The stratified SVR12 rates were comparable regardless of baseline characteristics or week 4 viral decline among these regimens. Six (3.2%) patients had serious adverse events which were not related to treatment. The rates of fatigue, pruritus, and anemia tended to be higher in patients receiving RBV (22.0%, 19.5%, and 8.5%) combination than those receiving DCV (10.6%, 6.1%, and 1.5%) or LDV (10.3%, 5.1%, and 0%) combination. Conclusions Sofosbuvir in combination with RBV, DCV, or LDV for 12 weeks is effective and well‐tolerated for HCV‐2 patients. Compared with DCV or LDV combination, the risks of fatigue, pruritus, and anemia are higher in patients receiving RBV combination.

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Section: Discussionsupporting

confidence: 85%

Sofosbuvir‐based direct acting antiviral therapies for patients with hepatitis C virus genotype 2 infection

Liu

et al. 2019

J of Gastro and Hepatol

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“…mL when previously undetectable) of 1.4% in anti-HBc-positive/ HBsAg-negative individuals with no major clinical events. The overall estimated risk of reactivation in HBsAg-positive patients with no previous indication for NA therapy was 24%, with the elevation of ALT of two or more times the upper limit of normal in 9% of cases 21. These data support the current recommendation of mandatory assessment of HBV status before starting DAAs and prophylactic NAs in HBsAg-positive patients up to 12 weeks after DAAs discontinuation.…”

supporting

confidence: 69%

Optimal management of chronic hepatitis B patients receiving nucleos(t)ide analogues

Buti

Roade

Riveiro‐Barciela

et al. 2020

Liver International

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Management of chronic hepatitis B (CHB) is still considered a challenge in clinical practice. Patients must be carefully evaluated before starting therapy. This includes virology and laboratory assessments, an estimation of fibrosis by invasive and/or noninvasive methods, and an estimation of the risk of hepatocellular carcinoma (HCC). Nucleos(t)ide analogues (NAs) with a high barrier to resistance (tenofovir disoproxil fumarate [TDF], entecavir [ETV] and tenofovir alafenamide [TAF]) are the most frequently used treatments because of their good long‐term efficacy and tolerability. None of these options has been shown to be more effective than the other, but certain factors should be considered when selecting the best therapy for specific populations. Most patients achieve a virological and biochemical response to these agents, with a low rate of emerging resistance during long‐term treatment. However, the rate of hepatitis B surface antigen (HBsAg) loss is low and in most cases NAs therapy is lifelong. Safety concerns for long‐term NA use have become a priority in the management of CHB, in particular, the risk of impaired kidney function and bone marrow density loss described with TDF regimens. The risk of HCC is not completely eliminated by NAs. Thus, patients at higher risk should be identified and provided with appropriate surveillance.

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“…Anti‐HBV therapy is another consideration for these patients. For persons who test negative for HBsAg but positive for hepatitis B core antibodies (with or without hepatitis B surface antibodies) have resolved HBV infection, and no further workup or additional monitoring is needed …”

Section: Universal and Risk‐based Hepatitis C Screening And Follow‐upmentioning

confidence: 99%

“…For persons who test negative for HBsAg but positive for hepatitis B core antibodies (with or without hepatitis B surface antibodies) have resolved HBV infection, and no further workup or additional monitoring is needed. (92) Primary prevention measures for persons without coinfection include counseling about how to avoid contracting HIV and HBV and immunization against HBV and hepatitis A virus (HAV ) as needed. The CDC also recommends pneumococcal vaccination for all persons with chronic liver disease.…”

Section: Table 2 Measures To Prevent Hcv Transmissionmentioning

confidence: 99%

“…As with adults, testing for active HBV infection (i.e., HBsAg, anti-HBc, and anti-HBs) is recommended prior to initiating HCV DAA therapy in pediatric patients due to the risk for HBV reactivation during or after treatment. (92,294,295) Additionally, on-treatment and posttreatment glucose monitoring for hypoglycemia in children and adolescents with diabetes and INR monitoring in those taking warfarin is recommended due to potential alterations in doseresponse relationships associated with DAA-related HCV viral clearance. (141)(142)(143)(144)(145)(146)…”

Section: An 8-week Course Of the Daily F Ixed-dose Combination Of Glementioning

confidence: 99%

See 1 more Smart Citation

Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

2020

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Hepatitis B virus reactivation during direct-acting antiviral therapy for hepatitis C: a systematic review and meta-analysis

Cited by 138 publications

References 38 publications

Sofosbuvir‐based direct acting antiviral therapies for patients with hepatitis C virus genotype 2 infection

Sofosbuvir‐based direct acting antiviral therapies for patients with hepatitis C virus genotype 2 infection

Optimal management of chronic hepatitis B patients receiving nucleos(t)ide analogues

Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

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