6533b7d0fe1ef96bd125b77d

RESEARCH PRODUCT

The burden of HBV infection in HCV patients in Italy and the risk of reactivation under DAA therapy

Piero Luigi AlmasioFilomena MoriscoCaterina FurlanTommaso StroffoliniCaterina SagnelliNicola CoppolaAngelo AndriulliEvangelista SagnelliAntonina Smedile

subject

AdultLiver CirrhosisMaleHepatitis B virusmedicine.medical_specialtyHBsAgCirrhosisHBV reactivationHbv markersHbv reactivationPrevalenceHbv vaccinationHepacivirusChronic liver diseaseAntiviral Agents03 medical and health sciences0302 clinical medicineInternal medicinePrevalencemedicineHumansHepatitis B AntibodiesReimbursementAgedHepatitis B Surface AntigensHepatologyCoinfectionbusiness.industryGastroenterologyHCV therapyvirus diseasesHepatitis C ChronicMiddle AgedHepatitis Bmedicine.diseaseChronic HCV infection; HBV reactivation; HBV/HCV coinfection; HCV therapydigestive system diseasesHBV/HCV coinfectionItalyChronic HCV infection030220 oncology & carcinogenesisDNA ViralFemaleVirus Activation030211 gastroenterology & hepatologybusiness

description

Background: There is increasing awareness of HBV reactivation in HCV-RNA-positive/HBV-coinfected patients with chronic liver disease (CLD) treated with oral direct-acting antivirals (DAAs). Aim: To provide figures on the prevalence of HBV markers in HCV-RNA-positive subjects in Italy, where these findings are lacking. Methods: All subjects aged ≥18 years with CLD consecutively referring to Italian liver units located throughout country were prospectively enrolled in two national surveys in 2001 and 2014. Results: The total number of HCV-RNA-positive cases was 6984; 356 (5.1%) subjects vaccinated against HBV were excluded. A total of 6628 cases were evaluated. The prevalence rates of HBsAg, isolated anti-HBc and anti-HBc/anti-HBs-positivity were 2.9%, 8.1% and 14.7%, respectively. Among the estimated one million HCV-RNA-positive subjects in Italy, a substantial number of subjects are at risk of HBV reactivation due to DAA therapy. The prevalence of liver cirrhosis was higher than that of CLD in HBsAg-positive subjects (4.4% vs. 2.6%, p < 0.01) but not in those positive for other HBV markers. Conclusions: These findings outline the burden of HBV markers among HCV-RNA-positive subjects in Italy, where in 2017 reimbursement for DAA therapy by the National Health System became universal for all patients with chronic HCV infection. HBV vaccination coverage should be greatly extended, since nearly two thirds of subjects in this study resulted negative for any HBV marker.

yearjournalcountryeditionlanguage
2019-03-01
10.1016/j.dld.2018.09.010http://hdl.handle.net/11573/1277764