Clinical

HBV coinfection linked to reduced efficacy of anti-HCV therapy

Last Updated: 2007-08-28 10:10:03 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In patients chronically infected with hepatitis C virus (HCV), occult coinfection with hepatitis B virus (HBV) appears to decrease the efficacy of anti-HCV therapies, regardless of the viral genotype, new research suggests.

A substantial proportion of patients with chronic hepatitis C have been shown to have occult infection with HBV, but the clinical consequences of this finding are unclear, senior author Dr. C. Trepo, from Hopital Hotel Dieu, from Lyon, France, and colleagues note.

To investigate, the researchers performed serum HBV-DNA testing in 203 patients with chronic hepatitis C and no hepatitis B surface antigen. According to the report in the Journal of Medical Virology for August, 47 patients were found to have an occult HBV infection.

Patients with and without HBV infection were comparable in terms of age, gender, serum ALT level, HCV genotypes, and the presence of antibody to hepatitis B core antigen (anti-HBc), the report indicates. By contrast, those with HBV infection had more active histologic disease and advanced fibrosis.

A sustained response to anti-HCV combination therapy was noted in 28% of HBV-positive patients compared with 45% of HBV-negative patients (p < 0.05).

Among HBV-negative patients, HCV genotype 1 was associated with a worse response to therapy than other genotypes. When HBV-positive patients were included in the analysis, this significant finding disappeared.

The findings suggest that roughly one in four HCV-infected patients are also infected with HBV and that this finding is predictive of a worse response to anti-HCV therapy, the authors conclude. Further studies are needed to better understand the mechanisms involved.

J Med Virol 2007;79:1075-1081.