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2015 ; 28
(2
): 221-228
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The spectrum of HBV/HCV coinfection: epidemiology, clinical characteristics,
viralinteractions and management
#MMPMID25830779
Konstantinou D
; Deutsch M
Ann Gastroenterol
2015[Apr]; 28
(2
): 221-228
PMID25830779
show ga
Monoinfection with either hepatitis B (HBV) or C virus (HCV) represents one of
the major causes of chronic liver disease globally. However, in endemic areas a
substantial number of patients are infected with both viruses mainly as a result
of the common routes of transmission. Numerous studies have demonstrated that
dually infected patients carry a greater risk of advanced liver disease,
cirrhosis and hepatocellular carcinoma compared with monoinfected patients. The
choice of treatment is based on the virological profile of each patient taking
into account the dominant virus pattern. In predominant HCV, standard combination
treatment with pegylated interferon and ribavirin has proven equally effective in
HBV/HCV-coinfected patients as well as in HCV-monoinfected patients. Strikingly,
approximately 60% of patients with inactive HBV infection before HCV treatment
may present HBV reactivation while others experience hepatitis B surface antigen
seroconversion after clearing HCV, demonstrating the complexity of the
interaction between the two viruses during the follow up. The therapeutic
strategies for the predominant HBV dually infected patients are more vague,
although high genetic barrier nucleos(t)ide analogues play an indisputable role.
Finally, the recently approved combination treatments for chronic hepatitis C
containing direct-acting antivirals may definitely change the treatment protocols
in the future although there is no experience with these drugs in dually infected
patients until today.