Incidence of Reactivation of Hepatitis B in Co- infected HB V/HCV patients treated with Regiments of Sofosbuvir and Daclatasvir with or without Ribavirin

Abstract

H CV management was dramatically changed by the recent advent of direct-acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection, where DAA regimens are associated with a sustained virological response (SVR) rate of > 90–95% and are considered safe; nevertheless, a few complications have been reported including reactivation of hepatitis B virus (HBV). Recommendations have been made by the American Association for the Study of Liver Diseases (AASLD)/ Infectious Diseases Society of America (IDSA) and European Association for the Study of the Liver (EASL) to screen all CHC patients before DAA therapy for hepatitis B surface antigen (HBsAg), hepatitis B surface antigen, whether serum or plasma HBV DNA measurement is necessary. So, we assessed the potential risk of hepatitis B virus (HBV) reactivation in patients receiving direct-acting antiviral agent (DAA)-based therapy for patients with chronic HCV Study design: Hepatitis B virus (HBV) may reactivate when treating chronic hepatitis C (CHC) with direct-acting antivirals (DAA). We aimed to investigate the risk of HBV infection and reactivation during DAA therapy by performing a prospective observational study carried on 90 patients positive for chronic HCV who were candidates for treatment by DAA therapy according to the Egyptian guidelines from May 2019 to October 2020; the patients identified to carry HBsAg at baseline or with positive HBc Abs were further assessed for other HBV markers: hepatitis Be antigen at baseline, and serum HBV DNA quantitative measurement at baseline, week 12 of treatment. 24 week from start treatment. This study was held in out in centers for treatment of HCV in – Ain Shams University Hospital and Aswan Fever Hospital. Hospital from May 2019 to October 2020., All patients were subjected to history taking, clinical examination, abdominal ultrasound, laboratory investigations (CBC, liver function,, HCV Ab, HBsAg, HBV eAg PCR for HCV RNAand PCR for HBV DNA. All patients were positive for HCVAb,HCV PCR, HBVsAg with HBV DNA less than 2000IU/ML and negative for HBVeAg. This study was conducted on 90patients who were selected according to National Committee for Control of Viral Hepatitis (NCCVH) protocol were divided according to treatment protocol into two groups. Group A: Included 57 patients who received Sofosbuvir plus Daclatasvir for 12 weeks.