title: Reactivation of Herpesvirus in Patients With Hepatitis C Treated With Direct-Acting Antiviral Agents.
abstract: We performed a case-series analysis of reactivation of herpesvirus in patients with hepatitis C virus (HCV) infection treated with direct-acting antiviral (DAA) agents. We collected data from 576 patients with HCV infection treated with DAA combinations at 3 hospitals in Spain, from November 2014 through November 2015. We also collected data from a control population (230 HCV-infected patients, matched for sex and age; 23 untreated and 213 treated with interferon-based regimens). Herpesvirus was reactivated in 10 patients who received DAA therapy (7 patients had cirrhosis and 3 patients had received liver transplants), a median of 8 weeks after the therapy was initiated. None of the controls had herpesvirus reactivation. Patients with herpesvirus reactivation were receiving the DAA agents sofosbuvir with ledipasvir (with or without ribavirin, 7/10), ombitasvir with paritaprevir and ritonavir plus dasabuvir (with or without ribavirin, 2/10), or sofosbuvir with simeprevir plus ribavirin (1/10). Two of the 10 patients developed postherpetic neuralgia and 1 patient developed kerato-uveitis. All 10 patients with herpesvirus reactivation achieved a sustained virologic response. Immune changes that follow clearance of HCV might lead to reactivation of other viruses, such as herpesvirus. Patients with HCV infection suspected of having herpesvirus infection should be treated immediately. Some groups also might be screened for herpesvirus infection.
authors.affiliation: Liver Unit, Puerta de Hierro University Hospital, Instituto de Investigación Sanitaria Puerta de Hierro-Majadajonda, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Majadahonda, Madrid, Spain.
authors.forename: Christie
authors.initials: C
authors.lastname: Perelló M
authors.affiliation: Liver Unit, Puerta de Hierro University Hospital, Instituto de Investigación Sanitaria Puerta de Hierro-Majadajonda, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Majadahonda, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Carrillo
authors.affiliation: Liver Unit, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.
authors.forename: María-Carlota
authors.initials: MC
authors.lastname: Londoño
authors.affiliation: Digestive Service, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Arias-Loste
authors.affiliation: Liver Unit, Puerta de Hierro University Hospital, Instituto de Investigación Sanitaria Puerta de Hierro-Majadajonda, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Majadahonda, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Hernández-Conde
authors.affiliation: Digestive Service, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Llerena
authors.affiliation: Digestive Service, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Crespo
authors.affiliation: Liver Unit, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Forns
authors.affiliation: Liver Unit, Puerta de Hierro University Hospital, Instituto de Investigación Sanitaria Puerta de Hierro-Majadajonda, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Majadahonda, Madrid, Spain. Electronic address: joseluis.calleja@uam.es.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Calleja
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006564:Herpesviridae / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D016849:Keratitis, Herpetic / Q000139:chemically induced; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000139:chemically induced; D013030:Spain; D014775:Virus Activation / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents
keywords: Antiviral Immune Response; Hepatitis C Virus; Varicella-Zoster Virus; Viral Reactivation