Korean J Hepatol.  2011 Sep;17(3):199-205. 10.3350/kjhep.2011.17.3.199.

Clinical features and treatment efficacy of peginterferon alfa plus ribavirin in chronic hepatitis C patients coinfected with hepatitis B virus

• Kim YJ
• Lee JW
• Kim YS
• Jeong SH
• Kim YS
• Yim HJ
• Kim BH
• Lee CK
• Park CK
• Park SH

• KMID: 1025199
• DOI: http://doi.org/10.3350/kjhep.2011.17.3.199

Abstract

BACKGROUND/AIMS
Cross-sectional studies have documented that 2-10% of patients who are chronically infected with hepatitis C virus (HCV) are also positive for hepatitis B virus (HBV) surface antigen (HBsAg). Data related to HCV-HBV coinfection are lacking in Korea. This study evaluated the clinical characteristics, the treatment efficacy of peginterferon alfa plus ribavirin, and the changes induced by such treatment in HBV status in chronic hepatitis C (CHC) patients coinfected with HBV.
METHODS
Eighteen (2.37%) HBsAg-positive CHC patients were selected from among the 758 subjects from the K(G)yeonggi-Incheon Peginterferon alfa and ribavirin in chronic hepatitis C Treatment (KIPECT) study, which evaluated the treatment efficacy and safety of peginterferon alfa plus ribavirin in CHC patients. Data on changes in the status of HBV infections were obtained.
RESULTS
HCV genotype 1b was the most common (44%). The overall sustained virologic response rate was 72% in all patients, and 60% and 87.5% in genotypes 1 and 2, respectively. Two of the 18 patients were positive for HBeAg, and 15 had baseline HBV DNA level of less than 2,000 IU/mL. Two of the three whose levels exceeded this threshold showed no detectable DNA after treatment. After the completion of treatment, serum HBV DNA levels were increased in the two patients whose baseline HBV DNA levels were less than 2,000 IU/mL.
CONCLUSIONS
The prevalence of HBV coinfection in CHC patients was 2.37% and most of the patients were inactive carriers. The treatment efficacy was similar to that of HCV mono-infection. Reactivation of HBV replication was observed in some patients after CHC treatment.

Keyword

Hepatitis B virus; Hepatitis C virus; Coinfection

MeSH Terms

Adult
Antiviral Agents/*therapeutic use
Cross-Sectional Studies
DNA, Viral/blood
Drug Therapy, Combination
Female
Genotype
Hepatitis B Surface Antigens/blood
Hepatitis B e Antigens/blood
Hepatitis B, Chronic/*complications/genetics
Hepatitis C, Chronic/complications/*drug therapy/pathology
Humans
Interferon-alpha/*therapeutic use
Male
Middle Aged
Polyethylene Glycols/*therapeutic use
Recombinant Proteins/therapeutic use
Ribavirin/*therapeutic use