Conclusion: Twenty-two studies reported hepatitis (inflammation of the liver) due to hepatitis B reactivation. The HCV SVR/cure rate was 47% in the hepatitis B/HCV coinfected groups—43% in the IFN treatment group and 100% in the DAA group. The overall hepatitis B reactivation rate was 12.3%, but the rate of hepatitis was 0.3% (0-1.1% in patients treated with interferon vs. 0.2-33.2%) in patients treated with DAAs. What was interesting was hepatitis B reactivation occurred in the post-treatment interferon groups (3 to 72 months) compared to DAA groups (4 to 11 week during treatment).
Editorial Comments: As the meta-analysis reports the chances of reactivation of hepatitis B are high, but the rate of hepatitis damage is relatively low. This should reinforce the need to test for hepatitis B before HCV treatment and if hepatitis B is negative to vaccinate before HCV treatment. If someone is positive for hepatitis B or if they have been previously infected and cleared of acute hepatitis B infection they should be carefully monitored during and after treatment for hepatitis B reactivation. The careful monitoring will prevent liver damage and possible death by treating hepatitis B with antiviral medications as needed. For more information about the FDA warning visit our blog for the announcement or our new Easy C fact sheet HEP C TREATMENT WARNING: Beware of Hepatitis B 1
1 Easy C Fact Sheet: Beware of Hepatitis B.
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