Entecavir Prevents HBV Reactivation During Direct Acting Antivirals for HCV/HBV Dual Infection: A Randomized Trial

Pin Nan Cheng, Chun Jen Liu, Chi Yi Chen, Kuo Chih Tseng, Ching Chu Lo, Cheng Yuan Peng, Chih Lin Lin, Hung Chih Chiu, Yen Cheng Chiu, Pei Jer Chen

研究成果: Article同行評審

8 引文 斯高帕斯(Scopus)

摘要

Background & Aims: A strategy to prevent hepatitis B virus (HBV) virologic reactivation (HBVr) and clinical reactivation (CR) during direct acting antiviral (DAA) treatment of hepatitis C virus (HCV)/HBV dual infection remains an unresolved issue. Methods: Noncirrhotic patients with dual HCV/HBV infection were enrolled and allocated randomly to 1 of 3 groups as follows: 12 weeks of DAA alone (group 1), 12 weeks of DAA plus 12 weeks of entecavir (group 2), or 12 weeks of DAA plus 24 weeks of entecavir (group 3). The entire study duration was 72 weeks. The primary end point was the occurrence of HBVr (defined by an increase of HBV DNA level >10-fold with quantifiable HBV DNA at baseline or the presence of HBV DNA with prior unquantifiable HBV DNA) and CR (defined by serum alanine aminotransferase level >2-fold the upper limit of normal in addition to HBVr). Results: Fifty-six patients were allocated randomly as follows: 20 patients in group 1, 16 patients in group 2, and 20 patients in group 3. In group 1, HBV DNA levels increased significantly as early as 4 weeks after initiation of DAA and persisted until the end of the study. During DAA treatment, HBVr occurred in 50% in group 1 vs 0% in group 2 and 0% in group 3 (P <.001), whereas the majority of HBVr in groups 2 and 3 occurred 12 weeks after cessation of entecavir (cumulative incidence, 93.8% in group 2 and 94.7% in group 3). Three patients (5.4%; 1 in each group) showed CR at week 48 and did not receive entecavir treatment. Conclusions: Twelve weeks of entecavir is suggested to be co-administered with DAA for HCV/HBV dually infected patients. ClinicalTrials.gov no: NCT04405011.

原文English
頁(從 - 到)2800-2808
頁數9
期刊Clinical Gastroenterology and Hepatology
20
發行號12
DOIs
出版狀態Published - 2022 12月

All Science Journal Classification (ASJC) codes

  • 肝病
  • 消化內科

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