Sistema Gastrointestinal e Digestivo

Abstrato

Efficacy of Treatments for Patients with Chronic Liver Disease due to Coinfection with Hepatitis B and C Viruses

Toru Shizuma

The hepatitis B virus (HBV) and the hepatitis C virus (HCV) are the leading causes of chronic liver disease. Patients with chronic liver disease who are co infected with both HBV and HCV develop cirrhosis and hepatocellular carcinoma (HCC) more rapidly than patients with monoinfection with HBV alone or HCV alone. However, standard-of-care recommendations have not been well established for patients with HBV/HCV co infection. In this study, a literature review was conducted on the efficacy of therapies for patients with HBV/HCV coinfection. Many papers reported that following combination therapy with interferon (IFN) plus ribavirin (RBV), there were no significant differences in the rate of achievement of a sustained virological response (SVR) to HCV between patients with HBV/HCV coinfection and patients with HCV monoinfection. However, the efficacy of these therapies for HBV infection in coinfected patients is complex. In patients with HBV/HCV coinfection characterized by a predominance of HCV, it is highly probable for serum hepatitis B surface antigen (HBsAg) titers to decrease or disappear during or after IFN/RBV combination therapy. On the other hand, reactivation of HBV due to the suspected inhibition of HCV replication is sometimes detected in coinfected patients during or after IFN/RBV combination therapy.