BACKGROUND: There are controversial data on possible occult hepatitis B virus (HBV) reactivation in hepatitis C virus (HCV) patients successfully treated with direct-acting antivirals (DAA). However, diagnosis of occult HBV infection (OBI) was not performed by gold standard procedures in any study. METHODS: By using several highly sensitive assays, we examined serially collected serum samples from 40 HBV-surface-negative DAA-treated HCV patients with OBI identified by testing liver biopsy specimens through nested-PCR technique. Serum samples were obtained at four time points from each patient (at baseline, at 4 weeks after starting, at the end, and 12 weeks after stopping therapy), and tested for HBV-DNA by nested-PCR and real-time PCR techniques. RESULTS: All tested serum samples were negative by both quantitative HBV surface antigen (HBsAg) and HBV-core-related antigen assays. Twenty-six/40 patients were anti-HBs positive and in all of them, the amount of this antibody was stable at the four time points evaluated. Serum HBV-DNA was detected in 10 samples at baseline, in 6 samples 4 weeks after starting therapy, in 11 samples at the end of therapy and in 21 samples 12 weeks after stopping treatment (P=0.001). Aminotransferase values dropped within the normal levels at week four of therapy and persisted normal over time in all cases. CONCLUSIONS: A slight increase in the amount of HBV-DNA three months after stopping DAA therapy was the only parameter showing a possible reappearance of HBV activity in OBI patients cured for a concomitant HCV infection, but it was insufficient to lead toward a virological reactivation capable of inducing liver injury.

Behaviour of occult HBV infection in HCV-infected patients under treatment with direct-acting antivirals

Musolino, Cristina
Primo
;
Cacciola, Irene;Lombardo, Daniele;Raffa, Giuseppina;Alibrandi, Angela;Squadrito, Giovanni;Raimondo, Giovanni;Pollicino, Teresa
Ultimo
2019

Abstract

BACKGROUND: There are controversial data on possible occult hepatitis B virus (HBV) reactivation in hepatitis C virus (HCV) patients successfully treated with direct-acting antivirals (DAA). However, diagnosis of occult HBV infection (OBI) was not performed by gold standard procedures in any study. METHODS: By using several highly sensitive assays, we examined serially collected serum samples from 40 HBV-surface-negative DAA-treated HCV patients with OBI identified by testing liver biopsy specimens through nested-PCR technique. Serum samples were obtained at four time points from each patient (at baseline, at 4 weeks after starting, at the end, and 12 weeks after stopping therapy), and tested for HBV-DNA by nested-PCR and real-time PCR techniques. RESULTS: All tested serum samples were negative by both quantitative HBV surface antigen (HBsAg) and HBV-core-related antigen assays. Twenty-six/40 patients were anti-HBs positive and in all of them, the amount of this antibody was stable at the four time points evaluated. Serum HBV-DNA was detected in 10 samples at baseline, in 6 samples 4 weeks after starting therapy, in 11 samples at the end of therapy and in 21 samples 12 weeks after stopping treatment (P=0.001). Aminotransferase values dropped within the normal levels at week four of therapy and persisted normal over time in all cases. CONCLUSIONS: A slight increase in the amount of HBV-DNA three months after stopping DAA therapy was the only parameter showing a possible reappearance of HBV activity in OBI patients cured for a concomitant HCV infection, but it was insufficient to lead toward a virological reactivation capable of inducing liver injury.
File in questo prodotto:
File Dimensione Formato  
Antiviral Therapy 2018 10.3851@IMP3288.pdf

solo utenti autorizzati

Descrizione: ARTICOLO SU RIVISTA
Tipologia: Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 212.74 kB
Formato Adobe PDF
212.74 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
3134893.pdf

solo utenti autorizzati

Tipologia: Versione Editoriale (PDF)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 2.88 MB
Formato Adobe PDF
2.88 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11570/3134893
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 6
social impact