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Management of hepatitis B and hepatitis C coinfection: an expert review

Dorota Zarębska-Michaluk1, Robert Flisiak2, Marta Flisiak-Jackiewicz3

  • 1Department of Infectious Diseases, Jan Kochanowski University , 25-640, Kielce, Poland.

Expert Review of Anti-Infective Therapy
|June 25, 2020
PubMed

Insights

Hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection requires careful management, especially regarding HBV reactivation during HCV treatment with direct-acting antivirals (DAA). This review offers guidance for managing coinfection and preventing HBV reactivation.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Hepatitis B virus (HBV) and hepatitis C virus (HCV) share transmission routes, leading to coinfection.
  • HBV/HCV coinfection can alter disease progression and treatment responses.
  • Interactions between HBV and HCV impact infection mechanisms and therapeutic outcomes.

Purpose of the Study:

  • To review the epidemiology and current therapies for HBV/HCV coinfection.
  • To discuss drug-drug interactions in coinfected patients.
  • To focus on HBV reactivation risk during HCV treatment with direct-acting antivirals (DAA) and analyze management guidelines.

Main Methods:

  • Literature review of epidemiology and therapeutic options for HBV/HCV coinfection.
  • Analysis of drug-drug interactions.
  • Examination of HBV reactivation during DAA therapy for HCV.
  • Evaluation of international and national guidelines.

Main Results:

  • HBV/HCV coinfection presents complex therapeutic challenges.
  • Direct-acting antivirals (DAA) for HCV treatment pose a risk of HBV reactivation.
  • Existing guidelines for managing HBV reactivation in coinfected patients are inconsistent.

Conclusions:

  • A proposed management strategy for HBV/HCV coinfected patients, emphasizing HBV reactivation prevention during DAA therapy, is presented.
  • Recommendations for future guidelines on managing HBV/HCV coinfection are provided.
  • Addressing HBV reactivation is crucial for safe and effective HCV treatment in coinfected individuals.
Abstract

Keywords:
CoinfectionHBVHCVlivermanagementtherapy

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