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A new update to the guidelines for the treatment of hepatitis C recommends testing for the hepatitis B virus in all patients who are planning treatment with direct acting antiviral drugs.
Hepatitis B (HBV) and C (HVC) are diseases caused by different viruses that can both start as acute infections but turn chronic in some people, eventually leading to life-threatening liver damage, according to the Centers for Disease Control and Prevention. While there are vaccines to prevent hepatitis A and B, there is no vaccine for hepatitis C.
Health officials estimate that some 3.5 million people in the U.S are infected with hepatitis C. New direct-acting antiviral drugs approved in the last few years to treat the chronic infection of the virus have shown high cure rates with fewer side effects than traditional treatments with interferon.
The recommendation that calls for all patients beginning HCV treatment using direct acting antiviral (DAA) therapies be assessed for HBV is included in an update posted on HCVguidelines.org, the website sponsored by American Association for the Study of Liver Diseases, the Infectious Diseases Society of America and the International Antiviral Society-USA. It is based on an increase in the hepatitis B virus seen in some patients, according to a news release posted on the site.
“Cases of HBV reactivation (an increase of the HBV virus) during or after DAA therapy for HCV have been reported in HBV/HCV co-infected patients who were not already on HBV suppressive therapy,” Raymond Chung, MD, co-chair of the HCV Guidance Panel, stated in the release. “The severity of these cases have ranged from mild to severe fulminant liver injury that can be life threatening. While we do not know how frequently this occurs, the Guidance Panel recommends HBV testing for all patients beginning DAA treatment for HCV.”
The guidance panel also recommends that all susceptible individuals receive HBV vaccination and HBV DNA testing before DAA therapy in patients who are HBsAG positive. It also calls for starting patients who meet criteria for treatment of active HBV infection on therapy either at the same time or before patients start HCV DAA therapy.
In addition, it recommends that patients with low or undetectable HBV DNA levels be monitored regularly for HBV reactivation during treatment and that those whose HBV DNA levels meet treatment criteria be given HBV therapy as recommended by the guidelines.
“While there currently isn’t enough data to make clear recommendations for patients who have been exposed to HBV and resolved the virus, whether spontaneous or after antiviral therapy, we recommend these patients be monitored for HBV reactivation,” Susanna Naggie, MD, co-chair of the HCV Guidance Panel, stated in the release. “This is particularly important in the event of unexplained increases in liver enzymes and during and/or after completion of DAA therapy.”
– See more at: http://www.hcplive.com/medical-news/hepatitis-c-treatment-panel-calls-for-hepatitis-b-testing#sthash.rMnu13b9.dpuf