The negative impact of HBV/HCV coinfection on cirrhosis and its consequences

Abstract

HCV coinfection harmfully affects liver fibrosis in HBV patients, while decompensated cirrhosis is increased in coinfected patients compared with HBV- or HCV-monoinfected patients. HCV treatment is as safe and effective in coinfected as monoinfected patients and should be considered following the same rules as HCV monoinfected patients.

Letter: more studies are needed to elucidate the impact of HBV/HCV coinfection on cirrhosis and its consequences

“…1,2 Regarding the lack of liver biopsy in all the patients, we do agree that several noninvasive markers are available for evaluating HBV infection-related fibrosis 3,4 and that it should be better to have a liver biopsy in all the patients. Although all the patients had either a liver biopsy or a noninvasive evaluation at the beginning of medical care, we had to take into account a risk of misclassification which could have been dually increased by the discrepancies observed between noninvasive fibrosis markers and the significant decrease in fibrosis scores linked to viral suppression but also to a potential deterioration related to liver comorbidities.…”

“…[2][3][4] In the study, the authors analysed the comorbidities such as arterial hypertension and diabetes among different groups. 1 However, the coexistences with other comorbidities such as nonalcoholic fatty liver diseases were not described by the authors. Severe steatosis was significantly associated with increased fibrosis in both HBV-and HCVinfected patients.…”

“…1 They found that HCV coinfection adversely affects liver fibrosis in HBV patients, while decompensated cirrhosis is increased in coinfected patients as compared with HBV-or HCV-monoinfected patients. 1 The study is very interesting and important. Although these data provide more evidence about the impact of HBV/HCV coinfection on cirrhosis and its consequences, several issues are worthy of discussion.…”

“…1 Instead, they evaluated the liver fibrosis stage by liver biopsy with less than 6 months from entry in (n = 107), or using the most recent evaluation of liver stiffness (n = 345), Fibrotest or Fibrometer (n = 36), or both (n = 90). 1 However, different non-invasive markers of fibrosis have different sensitivity and specificity in staging liver fibrosis. [2][3][4] In the study, the authors analysed the comorbidities such as arterial hypertension and diabetes among different groups.…”

Treatment of hepatitis C: the use of the new pangenotypic direct‐acting antivirals in “special populations”

“…Around 5% of patients have HBV/HCV co‐infection. This co‐infection is known to be associated with an increased risk of severe liver disease (cirrhosis and/or hepatocellular carcinoma), compared to mono‐infections. This could suggest that most HBV/HCV co‐infected patients require antiviral therapy against both HCV and HBV infection with similar SVR rates .…”