Impact of Hepatitis B Exposure on Sustained Virological Response Rates of Highly Viremic Chronic Hepatitis C Patients

Abstract EN

Aim.

To evaluate the impact of hepatitis B core antibody (anti-HBc) seropositivity in sustained virological response (SVR) rates in treatment-naïve, chronic hepatitis C (CHC) patients with high pretreatment viral load (>800000 IU/mL).

Methods.

185 consecutive CHC patients (14.4% cirrhotics, 70.2% prior intravenous drug users) treated with pegylated interferon-a2b plus ribavirin, for 24 or 48 weeks based on viral genotype, were retrospectively analyzed.

SVR was confirmed by undetectable serum HCV-RNA six months after the end of treatment schedule.

Results.

Thirty percent of CHC/HBsAg-negative patients were anti-HBc-positive.

Anti-HBc positivity was more prevalent in cirrhotic, compared to noncirrhotic patients (76.9% versus 19.5%, P<.05).

Serum HBV-DNA was detected in the minority of anti-HBc-positive patients (1.97%).

Overall, 62.1% of patients exhibited SVR, while 28.6% did not; 71.4% of non-SVRs were infected with genotype 1.

In the univariate analysis, the anti-HBc positivity was negatively associated with treatment outcome (P=.065).

In the multivariate model, only the advanced stage of liver disease (P=.015) and genotype-1 HCV infection (P=.003), but not anti-HBc-status (P=.726), proved to be independent predictors of non-SVR.

Conclusion.

Serum anti-HBc positivity does not affect the SVR rates in treatment-naïve CHC patients with high pretreatment viral load, receiving the currently approved combination treatment.