Treatment of Chronic Hepatitis C in Adolescent Patients With Positive HBsAg or With Occult Hepatitis B: Is the Risk of Hepatitis B Reactivation Significant?

Theodor Bilharz Research Institute

Bibliographic Information

Authors: El-Khayat H.; Yakoot M.; El-Shabrawi M.; Fouad Y.; Attia D.; Kamal E.M.

Journal: Pediatric Infectious Disease Journal

Publisher: Lippincott Williams and Wilkins

Publication Date: 7 September 2020

Volume / Issue: Volume 40 / Issue 1

Pages: 11–15

ISSN: 8913668

DOI: 10.1097/INF.0000000000002894

Scopus: View on Scopus

PubMed: 32925546

Document Type: Article

Authors and Affiliations

El-Khayat H., Department of Gastroenterology, Hepatology and Endemic Medicine, Theodore Research Institute, Cairo, Egypt; Yakoot M., Green Clinic Research Centre, Alexandria, Egypt; El-Shabrawi M., Pediatrics Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt; Fouad Y., Department of Gastroenterology, Hepatology and Endemic Medicine, Minia University, Minia, Egypt; Attia D., Department of Hepatology, Gastroenterology and Endemic Medicine, Beni-Suef University, Beni-Suef, Egypt; Kamal E.M., Department of Gastroenterology, Hepatology and Endemic Medicine, Minia University, Minia, Egypt

Abstract

Background: Reactivation of hepatitis B virus (HBV) infection in patients treated for chronic hepatitis C (HCV) with direct-acting antiviral agents has emerged recently as an important safety issue; however, it has not been adequately studied in pediatric age groups. We aimed to evaluate this risk in adolescent patients infected with chronic HCV and positive for HBsAg and HBcAbs. Patients and methods: One hundred and fifteen adolescent patients from 12 to 17 years of age, infected with chronic HCV and positive for HBcAbs with or without HBsAg were included in this study. All patients were treated with 1 tablet daily of the fixed-dose combination sofosbuvir/ledipasvir for 12 weeks. Patients were closely monitored throughout the study for virus load, liver functions, and other safety and efficacy outcome measures. Results: The sustained virologic response 12 (SVR12) rates were 96.7% (95% confidence interval: 88.6-99.1%) in HBsAg positive group and 98.2% (95% confidence interval: 90.4-99.7%) in HBsAg negative with HBcAbs positive group. Throughout the treatment period and the 12 weeks follow-up after treatment, there has been no single case in both HBsAg negative or positive that showed any manifestation of reactivation of hepatitis B, detected levels of HBV-DNA, or deterioration of liver functions. Conclusion: No HBV reactivation was observed in adolescents treated for chronic HCV with direct-acting antiviral agents in our study, in both HBsAg positive or occult hepatitis B. Although results are reassuring, we still recommend close monitoring of liver functions to not miss even rare cases of such a potentially serious condition. © 2021 Lippincott Williams and Wilkins. All rights reserved.

Keywords

adolescents; chronic HCV; coinfection; HBV; hepatitis C virus; reactivation; Adolescent; Antiviral Agents; Child; Female; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis C, Chronic; Humans; Liver Function Tests; Male; Prospective Studies; Virus Activation; antivirus agent; hepatitis B surface antigen; blood; chronic hepatitis C; clinical trial; complication; drug effect; human; liver function test; multicenter study; pathophysiology; prospective study; virology

Citation Information

Scopus Citations: 4

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