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Updated: Oct 9, 2025

A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target
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A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target

Published on: May 10, 2022

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Pharmacotherapeutic strategies for hepatitis B and hepatitis C coinfection

Rachael Jacob1,2, Mark Danta1,2

  • 1Department of Gastroenterology, St Vincent's Hospital, Sydney, Australia.

Expert Opinion on Pharmacotherapy
|December 23, 2021
PubMed

Insights

Hepatitis B and C virus coinfection increases liver disease risk. Antiviral therapy for Hepatitis C virus has a moderate risk of Hepatitis B virus reactivation, but prophylactic treatment is not needed; monitor closely instead.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Hepatitis B (HBV) and Hepatitis C (HCV) infections cause significant global health burdens, leading to cirrhosis and liver cancer.
  • HBV/HCV coinfection is common in endemic areas, presenting diverse virologic profiles and increasing the risk of advanced liver disease.
  • Early diagnosis and antiviral therapy (AVT) are crucial for coinfected patients, but optimal treatment strategies remain unclear, especially regarding HBV reactivation during HCV AVT.

Purpose of the Study:

  • To summarize current data on HBV/HCV coinfection, including epidemiology, virologic interactions, and HBV reactivation risk.
  • To provide a framework for assessing and managing coinfected patients.
  • To clarify the need for prophylactic HBV treatment during HCV AVT.

Main Methods:

  • Literature review of HBV/HCV coinfection data.
  • Analysis of HBV reactivation risk during direct-acting antiviral (DAA) therapy for HCV.
  • Development of a clinical management framework.

Main Results:

  • A moderate risk of HBV reactivation exists in HBsAg-positive patients on HCV DAA treatment, though severe events are infrequent.
  • The risk of HBV reactivation is negligible in HBsAg-negative patients receiving HCV DAA treatment.
  • Prophylactic HBV treatment is not recommended for either group.

Conclusions:

  • Close monitoring for HBV reactivation or elevated ALT levels is recommended during HCV DAA therapy.
  • HBV treatment should be initiated if reactivation or significant ALT elevation occurs.
  • Current evidence does not support routine prophylactic HBV treatment for coinfected patients undergoing HCV DAA therapy.
Abstract

Keywords:
Coinfectiondirect-acting antiviralshepatitis Bhepatitis Creactivation

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