A severe hepatitis flare in an HBV-HCV coinfected patient during combination therapy with ?-interferon and ribavirin

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dc.contributor.authorYalcin, K
dc.contributor.authorDegertekin, H
dc.contributor.authorYildiz, F
dc.contributor.authorKilinc, N
dc.date.accessioned2024-04-24T16:01:55Z
dc.date.available2024-04-24T16:01:55Z
dc.date.issued2003
dc.departmentDicle Üniversitesien_US
dc.description.abstractWe report a reactivation of hepatitis B virus infection and a severe hepatitis flare in a patient with chronic hepatitis due to dual infection with hepatitis B and C viruses during combination therapy with alpha-interferon and ribavirin. Pretreatment, HCV was the dominant virus, with detectable serum HCV-RNA but undetectable HBV-DNA. The patient responded to therapy, with the disappearance of HCV-RNA and normalization of serum alanine aminotransferase (ALT) at months 1 and 6. In the seventh month of therapy, an ALT flare was observed, and serum HBV-DNA became detectable. The patient had a severe hepatitis flare leading to impending hepatic failure. Treatment was discontinued and the patient had marked clinical and biochemical improvement and recovered with normalization of liver function test results within 1 month. Two months later, serum HBV-DNA was again undetectable, both by hybridization and polymerase chain reaction (PCR) assays. The patient had a rapid progression to cirrhosis in a year. At month 24, 17 months after the end of therapy, serum HCV-RNA reappeared, with a level of 2.4 X 10(5) copies/ml. In conclusion, severe HBV reactivation may occur during interferon plus ribavirin therapy in patients with chronic hepatitis C who are also hepatitis B surface antigen (HBsAg)-positive, and thus more careful monitoring than usual should be considered. Longterm follow-up is recommended, because very late HCV relapses may occur in coinfected patients. These data exemplify the complexity of viral dominance in patients infected with multiple hepatitis viruses, and this has significant importance for treatment decisions. Lamivudine may be administered early in HCV-RNA/HBsAg-positive patients who ate at high risk of liver failure once reactivation of HBV occurs during interferon therapy.en_US
dc.identifier.doi10.1007/s00535-002-1149-5
dc.identifier.endpage800en_US
dc.identifier.issn0944-1174
dc.identifier.issue8en_US
dc.identifier.pmid14505137
dc.identifier.scopus2-s2.0-0141856578
dc.identifier.scopusqualityQ1
dc.identifier.startpage796en_US
dc.identifier.urihttps://doi.org/10.1007/s00535-002-1149-5
dc.identifier.urihttps://hdl.handle.net/11468/14501
dc.identifier.volume38en_US
dc.identifier.wosWOS:000185255500014
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSpringer-Verlag Tokyoen_US
dc.relation.ispartofJournal of Gastroenterology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectHbv/Hcv Dual Infectionen_US
dc.subjectAlpha-Interferonen_US
dc.subjectRibavirinen_US
dc.subjectFlareen_US
dc.titleA severe hepatitis flare in an HBV-HCV coinfected patient during combination therapy with ?-interferon and ribavirinen_US
dc.titleA severe hepatitis flare in an HBV-HCV coinfected patient during combination therapy with ?-interferon and ribavirin
dc.typeArticleen_US

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