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P1531 - A Retrospective Analysis of Hepatitis-B Reactivation in Hepatitis-C Patients Treated With Direct-Acting Antivirals Therapy

Monday, October 28

10:30 AM - 4:15 PM

Location: Exhibit Halls 3 and 4 (Street Level)

Presenting Author(s)

MT

Muhammad Tahir, MD

Buffalo, New York

Muhammad Tahir, MD¹, Naveen Prasad Gopalakrishnan Ravikumar, MD², Wijewardena Chathura, MD¹, Anthony Martinez, MD¹

¹Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; ²State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, NY

Introduction: Hepatitis B virus/hepatitis C virus (HBV/HCV) co-infection has a prevalence of 5%-10% in patients with chronic HCV patients. Direct-acting antiviral agent (DAA) have replaced Interferon (IFN)-based treatment for HCV infection given the increased HCV sustained virological response (SVR). However, the Food and Drug Administration (FDA) has issued warnings about HBV reactivation (HBV-R) in chronic HCV patients treated with DAA. We aimed to assess the HBV reactivation rate in our chronic HCV patient population treated with DAA (Ledipasvir / Sofosbuvir).

Methods: We conducted a retrospective study involving HCV patients treated with DAA at our outpatient hepatology clinic located in Erie county medical center. The goal as discussed above was to find the HBV reactivation which was defined as reverse seroconversion of HBsAg-negative patients at baseline becoming HBsAg-positive post DAA therapy with a DNA level > 0 IU/mL.

Patient characteristics and laboratory results at baseline and at the end of follow-up were retrospectively analyzed from electronic medical records. A chart review was completed for a total of 260 patients fulfilling the inclusion criteria.
The mean age of the study population was 56.5 years.

Inclusion criteria:
1-DAA therapy for HCV with confirmed SVR
2-HBsAg-negative/HbcAb +.
3-HBV/HCV coinfection

Exclusion criteria:
1- Coinfection of HAV/HDV/HEV
2- Decompensated cirrhosis with CPT class B/C
3- Active HBV coinfection
4- Undergoing immunosuppressive therapy or chemotherapy

Results: Post-treatment serum samples of 260 patients were analyzed. Of these, 19.60% (51/260) of the total population was positive for HbcAb. Out of these 51 patients, 13 post-DAA treatment patients were checked for hepatitis-B DNA level to rule out the concern for reactivation. None of the patients showed any elevation in Hepatitis-B virus DNA level, i.e. undetectable. Also, no seroconversion to HbsAg+ was noticed in our population post-DAA therapy. Further detailed results will be presented in the poster during meeting.

Discussion: To conclude, we found no hepatitis-B virus reactivation or seroconversion to HBsAg positive state in our cohort. Our study supports the latest literature that although it has been observed in the past, HBV reactivation in exposed patients with HbcAb without positive HbsAg is very rare.

Gender, Race and Genotype distribution in our patient population. Details will be discussed in poster.

HbcAb+ cohort in our study population. The next picture shows the HBV DNA level among HbcAb+ status. 25% show undetectable DNA level. The subset details will be discussed during poster presentation.

Disclosures:

Muhammad Tahir indicated no relevant financial relationships.

Naveen Prasad Gopalakrishnan Ravikumar indicated no relevant financial relationships.

Wijewardena Chathura indicated no relevant financial relationships.

Anthony Martinez indicated no relevant financial relationships.

Citation: Muhammad Tahir, MD; Naveen Prasad Gopalakrishnan Ravikumar, MD; Wijewardena Chathura, MD; Anthony Martinez, MD. P1531 - A RETROSPECTIVE ANALYSIS OF HEPATITIS-B REACTIVATION IN HEPATITIS-C PATIENTS TREATED WITH DIRECT-ACTING ANTIVIRALS THERAPY. Program No. P1531. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.