Patients
with HBV/HCV Coinfection May Experience HBV Relapse
after Sustained HCV Suppression
By
Liz Highleyman
Chinese researchers conducted a study to assess the
virological features of 50 patients coinfected with
HBV and HCV, as well as the efficacy of combination
therapy with pegylated
interferon alpha-2a (Pegasys) plus ribavirin in
this group.
Results
 |
92%
of the coinfected patients had HCV-dominant virus
strains, while 8% had mixed HCV- and HBV-dominant
strains. |
|
Coinfected
patients had an average HBV DNA level of 4.6 log10
copies/mL, significantly lower than the 5.9 log10
copies/mL seen in HBV monoinfected individuals. |
|
Coinfected
patients were also significantly less likely than
HBV monoinfected patients to be hepatitis B "e"
antigen (HBeAg) positive (12.0% vs 45.3%). |
|
Among
participants with HCV genotype 1, HBV/HCV coinfected
patients had significantly higher early response
rates compared with HCV monoinfected individuals: |
| |
|
Partial
early virological response (pEVR): 50.0%
vs 16.0%, respectively; |
|
End-of-treatment
virological response (ETVR): 90.0% vs 56.0%,
respectively). |
|
|
However,
the relapse rate among genotype 1 coinfected patients
was also higher (55.6% vs 21.4%). |
|
HBV/HCV
coinfected and HCV monoinfected patients, therefore,
had similar sustained virological response (SVR)
rates (40.0% vs 44.0%, respectively). |
|
There
were no significant differences in on-treatment
virological response, ETVR, relapse, or SVR rates
between coinfected and monoinfected patients with
HCV genotype 2. |
|
Coinfected
patients had a significantly greater incidence
of side effects compared with HCV monoinfected
individuals (30% vs 13%, respectively). |
|
Coinfected
participants who achieved sustained response were
nearly 4 times more likely to experience HBV reactivation
(i.e., increased HBV DNA) compared with those
who did not attain SVR (33.3% vs 8.7%.
|
In
coinfected patients, the study authors concluded,
"The replication of HBV was suppressed, and HCV
was the dominant virus strain."
"Compared
with HCV monoinfected patients, pEVR, ETVR, and relapse
rates of patients with genotype 1 in the coinfection
group were high, while they shared similar SVR rates,"
they continued. "HBV and HCV coinfection had
no impact on the rate of virological response for
genotype 2."
12/15/09
Department
of Infectious Diseases, Second Affiliated Hospital,
Harbin Medical University, Harbin, China.
Reference
J
Yu, LJ Sun, YH Zhao, and others. Analysis of the efficacy
of treatment with peginterferon alpha-2a and ribavirin
in patients coinfected with hepatitis B virus and
hepatitis C virus. Liver International 29(10):
1485-1493 (Abstract).
November 2009.
