Sustained hepatitis C virus clearance and increased hepatitis B surface antigen seroclearance in patients with dual chronic hepatitis C and B during posttreatment follow-up§

Authors

  • Ming-Lung Yu,

    1. Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital and Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan
    Search for more papers by this author
    • These authors contributed equally to this work.

  • Chuan-Mo Lee,

    1. Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
    Search for more papers by this author
    • These authors contributed equally to this work.

  • Chi-Ling Chen,

    1. Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Wan-Long Chuang,

    1. Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital and Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan
    Search for more papers by this author
  • Sheng-Nan Lu,

    1. Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
    Search for more papers by this author
  • Chen-Hua Liu,

    1. Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Shun-Sheng Wu,

    1. Changhua Christian Hospital, Changhua, Taiwan
    Search for more papers by this author
  • Li-Ying Liao,

    1. Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
    Search for more papers by this author
  • Hsing-Tao Kuo,

    1. Chi Mei Medical Center, Tainan, Taiwan
    Search for more papers by this author
  • You-Chen Chao,

    1. Tri-Service General Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Shui-Yi Tung,

    1. Chai-Yi Chang Gung Memorial Hospital, Chiayi, Taiwan
    Search for more papers by this author
  • Sien-Sing Yang,

    1. Cathay General Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Jia-Horng Kao,

    1. Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Wei-Wen Su,

    1. Changhua Christian Hospital, Changhua, Taiwan
    Search for more papers by this author
  • Chih-Lin Lin,

    1. Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
    Search for more papers by this author
  • Hung-Chih Yang,

    1. Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Pei-Jer Chen,

    1. Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Ding-Shinn Chen,

    1. Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    Search for more papers by this author
  • Chun-Jen Liu,

    Corresponding author
    1. Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    • M.D., Ph.D., Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 1 Chang-Te Street, Taipei 10002, Taiwan
    Search for more papers by this author
    • fax: (886)-2-23825962

  • for the Taiwan Liver-Net Consortium

    1. Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital and Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan
    Search for more papers by this author

  • Potential conflict of interest: Nothing to report.

  • This study was supported in part by grants from the Department of Health, National Science Council (100-2325-B-002-052 and 101-2325-B-002-073, Resource Center, National Research Program for Biopharmaceuticals), Executive Yuan, Taiwan; and National Taiwan University, Taiwan.

  • §

    Results of this study were presented at the 22nd Conference of the Asian Pacific Association for the Study of the Liver, Taipei, Taiwan, February 16-19, 2012, and at the 47th Annual Meeting of the European Association for the Study of the Liver, Barcelona, Spain, April 18-22, 2012.

Abstract

Patients dually infected with hepatitis C virus (HCV)/hepatitis B virus (HBV) have a higher risk of developing advanced liver disease or hepatocellular carcinoma compared with monoinfected patients. Yet, there is a similar rate of sustained virologic response (SVR) after peginterferon alfa-2a and ribavirin combination therapy in these patients compared with HCV-monoinfected patients and a high hepatitis B surface antigen (HBsAg) seroclearance rate. The durability of hepatitis C and B clearance in coinfected patients was investigated in a 5-year follow-up study. Patients with active HCV genotype 1, both HBV-coinfected (n = 97) and HBV-monoinfected (n = 110), underwent 48-week combination therapy with peginterferon alfa-2a plus ribavirin. In patients with active HCV genotype 2 or 3, both HBV-coinfected (n = 64) and monoinfected (n = 50) patients underwent 24-week combination therapy. A total of 295 (91.9%) patients completed treatment and 24 weeks posttreatment follow-up; 264 (89.5%) patients agreed to receive additional follow-up for up to 5 years after the end of treatment. After a median follow-up of 4.6 ± 1.0 years, six of the 232 patients achieving SVR developed HCV RNA reappearance, including five HCV genotype 1/HBV-coinfected patients and one HCV genotype 2/3-monoinfected patient. Subgenomic analysis of the HCV core gene indicated that five patients developed delayed recurrence of HCV infection. Overall, the cumulative recurrence rate of HCV infection was 2.3% (0.4%/year; 95% confidence interval [CI], 0.9%-5.5%). The cumulative HBsAg seroclearance rate was 30.0% (95% CI, 21.5%-42.0%); with 33.1% (95% CI, 21.8%-50.1%) in the 48-week combination therapy group and 24.3% (95% CI, 13.7%-42.9%) in the 24-week therapy group. Conclusion: Peginterferon alfa-2a and ribavirin therapy provides good HCV SVR durability and a high accumulative HBsAg seroclearance rate in patients who are coinfected with HCV and HBV. (HEPATOLOGY 2013;)

Ancillary