All patients beginning hepatitis C (HCV) treatment using direct acting antiviral (DAA) therapies should be assessed for hepatitis B (HBV), according the American Association for the Study of Liver Diseases/Infectious Diseases Society of America Guidance Panel, which provides up-to-date guidance on the treatment of hepatitis C on its website, HCVguidelines.org.
“Cases of HBV reactivation (an increase of the HBV virus) during or after DAA therapy for HCV have been reported in HBV/HCV co-infected patients who were not already on HBV suppressive therapy,” explains Raymond Chung, MD, co-chair of the HCV Guidance Panel. “The severity of these cases have ranged from mild to severe fulminant liver injury that can be life threatening. While we do not know how frequently this occurs, the Guidance Panel recommends HBV testing for all patients beginning DAA treatment for HCV.”
Additionally, the Guidance Panel recommends:
”While there currently isn’t enough data to make clear recommendations for patients who have been exposed to HBV and resolved the virus, whether spontaneous or after antiviral therapy, we recommend these patients be monitored for HBV reactivation,” says Susanna Naggie, MD, MHS, co-chair of the HCV Guidance Panel. “This is particularly important in the event of unexplained increases in liver enzymes and during and/or after completion of DAA therapy.”
Visit HCVguidelines.org for more information about these newest recommendations and to view other sections of the HCV Guidance.