Hepatitis B Reactivation with Hepatitis C Treatment
Last updated: July 2023
Testing for co-infections like hepatitis B is important when considering treatment for hepatitis C. The hepatitis B virus can either be chronic or resolved. The CDC states, “For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection. The risk for chronic infection is related to age at infection: approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults".1
Chronic hepatitis B
Hepatitis B can either be resolved, meaning the body’s immune system has cleared the virus in the acute phase or it can be chronic, meaning long-lasting with either being active or nonactive.
If hepatitis B becomes chronic, severe liver damage (such as cirrhosis) or liver cancer can occur. A person can be infected with more than one form of hepatitis at the same time, or be infected with both hepatitis and a condition like HIV. Guidelines recommend that patients who have hepatitis B also be tested for HIV, hepatitis C, and extrahepatic conditions.
Hep B and DAAs
The Lancet, a Gastroenterology and Hepatology publication, stated in a recent case study of patients with a co-infection of hepatitis B and C, “Direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection might pose a risk for hepatitis B virus (HBV) reactivation in patients coinfected with chronic or resolved HBV infection. The need for HBV antiviral prophylaxis during DAA treatment remains controversial. We aimed to analyze the absolute risk of HBV reactivation in patients with active or resolved HBV infection treated with DAAs for HCV infection”.
The case study concluded that hepatitis B reactivation occurs frequently in patients with chronic hepatitis B who are co-infected with hepatitis C when receiving direct-acting antiviral therapy for hepatitis C, but reactivation is rare among patients with resolved hepatitis B.
It was stated the used of additional antiviral treatment may be needed for patients who tested positive for hepatitis B surface antigen (HBsAg), particularly those with quantifiable HBV DNA.
Being under the care of a liver specialist like a hepatologist or gastroenterologist (physicians who specialize in liver disease and treatment) is best when dealing with all forms of hepatitis and treatment. If you have a co-infection, don’t assume all treatment is right for you. Your physician will help determine which treatment is best for your co-infection and condition as well as monitor you while in treatment and recovery.
Don’t delay. Get tested, get treatment, and receive the cure.