title: Co-infection with hepatitis B does not alter treatment response in chronic hepatitis C.
abstract: OBJECTIVE
  To investigate the clinical features and treatment response in patients with hepatitis B (HBV) and hepatitis C virus (HCV) co-infection receiving anti-HCV therapy.
  
  
  METHODS
  Patients with HBV/HCV co-infection, who were eligible for anti-HCV therapy, were included in the study. Patients had detectable HBsAg for at least 6 months and detectable HCV-RNA before the initiation of therapy. Primary end-point was the proportion of patients achieving sustained virological response (SVR). HBV serology and HBV-DNA results obtained during the follow-up were assessed to determine HBV clearance or reactivation after anti-HCV therapy.
  
  
  RESULTS
  There were 612 patients in the HCV cohort and 52 (8.5%) of them were HBV/HCV co-infected. Twenty-eight patients (20 male, mean age: 47 ± 12) received anti-HCV treatment and followed-up for a mean duration of 53 months (12-156). Fifteen patients received peginterferon/ribavirin combination while the remaining patients received standard interferon/ribavirin combination (n=6) or standard interferon monotherapy (n=7). Patients receiving interferon monotherapy were under chronic hemodialysis therapy. SVR was achieved in 14 (50%) patients at the end of follow-up. The proportion of patients with SVR in three treatment arms were not significantly different (P=0.78). Eight of 11 patients with detectable HBV-DNA cleared HBV-DNA during treatment. Seven (25%) patients experienced a rebound in HBV-DNA, and one patient experienced an acute hepatitis flare which was controlled by tenofovir therapy. Two (7%) patients cleared HBsAg and one of them was seroconverted to anti-HBs.
  
  
  CONCLUSIONS
  Co-infection with HBV does not have a negative impact on the efficacy of anti-HCV treatment, but HBV-DNA should be monitored to overcome the risk of HBV exacerbation.
authors.affiliation: Harran University, Faculty of Medicine, Department of Gastroenterology, Sanliurfa, Turkey. Electronic address: auyanikoglu@hotmail.com.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Uyanikoglu
authors.forename: Filiz
authors.initials: F
authors.lastname: Akyuz
authors.forename: Bulent
authors.initials: B
authors.lastname: Baran
authors.forename: Binnur Pinarbasi
authors.initials: BP
authors.lastname: Simsek
authors.forename: Fatih
authors.initials: F
authors.lastname: Ermis
authors.forename: Kadir
authors.initials: K
authors.lastname: Demir
authors.forename: Mine
authors.initials: M
authors.lastname: Gulluoglu
authors.forename: Selim
authors.initials: S
authors.lastname: Badur
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Kaymakoglu
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007372:Interferons / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D019562:Viral Load; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D007372:Interferons; C100416:peginterferon alfa-2a