The effect of HBV coinfection on the sustained virological response in patients with chronic HCV treated with direct acting antivirals

Abstract

Hepatitis C virus (HCV) is a globally prevalent pathogen and a leading cause of death and morbidity .Egypt has a very high prevalence of HCV and a high morbidity and mortality. In patients with dual chronic hepatitis B and C infection, the clinical presentations and disease outcomes are usually more severe than in patients with single hepatotropic virus infection. At this study we tried to compare between two groups group A infected with hepatitis C group B infected by hepatitis C and HBV as regard sustained virological response and effect of eradication of hepatitis c on hepatitis B. This study carried out on 50 Egyptian patients with chronic HCV infection Group A: 40 patients with chronic HCV infection with negative HBs Ag 21 patient received sofosbovir and ribavirin for 24 weeks, 11 patient received sofosbovir simeprevir for 12 weeks and 8 patient received sofosbovir ribavirin interferon for 12 weeks. Group B: 10 patients with chronic HCV infection with positive HBs Ag 6 patient received sofosbovir ribavirin for 24 weeks, 2 patient received sofosbovir simeprevir for 12 weeks and 2 patient received sofosbovir ribavirin interferon for 12 weeks . All studied patients were subjected to history taking.full physical-examination,including,abdominal examination Laboratory investigations which include CBC,Serum ALT, AST, Total and Direct Bilirubin-Serum Albumin-Prothrombin time-Serum Creatinine-Thyroid Stimulating Hormone (TSH) -Anti-nuclear antibody (ANA) HCV-PCR quantitative - HBsAg- HB core Ab, HBeAg, HBeAb and Serum HBV DNA by PCR (for group 2 only). Alpha fetoprotein (AFP). Radiological investigation: Abdominal Ultrasound. triphasic spiral CT abdomen in cases with suspected hepatic focal lesion or elevated AFP. In this study there is no statistacally significant as regarding age, sex between both groups In this study there is no statistically significant as regard Child score where 97,5 % are child A in group A ,100% in group B child A In our study there is no statistaclly significant as regard laboratory data which include HB plt albumin bilirubin between both groups .

There is no statistical significant difference regarding SVR between mono infected HCV patient and patients with combined HCV HBV infection. Relapse rate was higher in patients treated with sof-ribavirin . Large studies are needed to confirm this results of this study. Sof-ribavirin shouldn't be an alternatve treatment in chronic HCV in Egypt