title: Hepatitis B reactivation in patients with chronic hepatitis C undergoing anti-viral therapy with an interferon-free regimen.
abstract: A few cases of hepatitis B virus (HBV) reactivation during anti-viral therapy against hepatitis C (HCV) have been reported. However, the information regarding the real impact of this phenomenon is scarce.
  
  
  
  To evaluate the risk of HBV reactivation during anti-viral therapy against HCV with an interferon-free regimen with direct-acting anti-virals (DAAs).
  
  
  
  Observational and prospective study of 352 patients receiving DAAs therapy between September 2015 and May 2016. HBV-DNA and ALT levels were monitored at baseline, at week 4 of anti-viral therapy, at end of treatment and 12 weeks after treatment discontinuation in patients with HBV surface antigen (HBsAg) positive or HBV core antibody (anti-HBc) positive before starting anti-viral therapy.
  
  
  
  Ten (2.8%) and 64 (18%) patients were HBsAg and anti-HBc positive at baseline, respectively. Five (50%) of 10 HBsAg positive and one (1.6%) of 64 anti-HBc positive patients presented HBV virological reactivation (>1log increase in HBV-DNA levels). None of these patients presented clinical reactivation (increase in ALT levels).
  
  
  
  HBV virological reactivation is frequent in HBsAg+ patients receiving anti-viral therapy against HCV. However, HBV-DNA elevations were modest (<20 000 IU/mL) and without clinical impact (no ALT elevation).
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: M-C
authors.identifier: 0000-0002-6533-1586
authors.initials: MC
authors.lastname: Londoño
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Lens
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: Z
authors.initials: Z
authors.lastname: Mariño
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Bonacci
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Ariza
authors.affiliation: Liver Unit, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Broquetas
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Pla
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Bartres
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: M V
authors.initials: MV
authors.lastname: Adriani
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Rodríguez-Tajes
authors.affiliation: Microbiology Department, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Costa
authors.affiliation: Liver Unit, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Carrión
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Pérez-Del-Pulgar
authors.affiliation: Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Forns
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects* / Q000502:physiology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014775:Virus Activation / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens