Hepatitis B Virus Reactivation During Successful Treatment of Hepatitis C Virus With Sofosbuvir and Simeprevir and EDITORIAL
Clin Infect Dis. OCT 15, 2015 V.61 N.8 P.1304-1306
Jeffrey M. Collins, Kara Loren Raphael, Charles Terry, Emily J. Cartwright, Anjana Pillai, Frank A. Anania, and Monica M. Farley
1Division of Infectious Diseases, Department of Medicine
2Department of Medicine
3Division of Digestive Diseases, Department of Medicine
4Emory Transplant Center, Emory University School of Medicine
5Atlanta Veterans Affairs Medical Center, Georgia
Correspondence: Jeffrey M. Collins, MD, MPH, Emory University School of Medicine, Division of Infectious Diseases, Woodruff Memorial Bldg, Ste 2101, 1639 Pierce Dr, Atlanta, GA 30322 (firstname.lastname@example.org).
Treatment of hepatitis C virus with potent, interferon-free, direct-acting antiviral regimens with no activity against hepatitis B virus (HBV) may increase the risk for HBV reactivation in coinfected patients.
We present 2 cases of HBV reactivation during treatment with an all-oral regimen of simeprevir and sofosbuvir and discuss strategies to prevent HBV flare.
Clin Infect Dis. OCT 15, 2015 V.61 N.8 P.1307-1309
Editorial Commentary – Another Call to Cure Hepatitis B
Ashwin Balagopal and Chloe L. Thio
Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Correspondence: Chloe L. Thio, MD, Johns Hopkins University, Department of Medicine, 855 N Wolfe St, 5th Flr, Baltimore, MD 21287 (email@example.com).
Because curing chronic hepatitis B is not yet possible, reactivation of hepatitis B virus (HBV) occurs and is most commonly recognized in the setting of immunosuppression .
In this issue of Clinical Infectious Diseases, Collins et al give us another setting to monitor for HBV reactivation—curing hepatitis C with direct-acting antiviral agents (DAAs) in HBV/hepatitis C virus (HCV) coinfection .
When interferon alfa was the standard of care for HCV treatment, a meta-analysis demonstrated that HBV reactivation occurred in 31% of the patients who experienced a sustained virologic response and only 11% in those without a sustained virologic response .
However, interferon alfa is an immunomodulatory drug that affects HBV replication; therefore, it was unclear if HBV reactivation would occur with DAAs that have no activity against HBV. We now have proof that this can occur….