Hepatitis C virus/Hepatitis B virus coinfection: Current prospectives.

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Antiviral Therapy Pub Date : 2023-08-01 DOI:10.1177/13596535231189643
Quratulain Maqsood, Aleena Sumrin, Maryam Iqbal, Saima Younas, Nazim Hussain, Muhammada Mahnoor, Abdul Wajid
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引用次数: 1

Abstract

In endemic areas, hepatitis C virus (HCV)/hepatitis B virus (HBV) coinfection is common, and patients with coinfection have a higher risk of developing liver disease such as hepatocellular carcinoma, liver fibrosis and cirrhosis. In such cases, HCV predominates, and HBV replication is suppressed by HCV. HCV core proteins and interferons that are activated by HCV are responsible for the suppression of HBV. Immunosuppression is also seen in patients with HCV and HBV coinfections. A decrease in HCV-neutralizing antibody response and circulation of Th1-like Tfh cells is observed in patients with HCV and HBV coinfection. Both viruses interacted in the liver, and treatment of HCV/HBV coinfection is genotype-based and complex due to the interaction of both viruses. In HCV-dominant cases, direct-acting antiviral drugs and peg interferon plus ribavirin are used for the treatment, with continuous monitoring of AST and ALT. HBV-dominant cases are less common and are treated with peg interferon and nucleoside nucleotide analogues with monitoring of AST and ALT. The SVR rate in HCV-HBV coinfection is higher than that in monoinfection when treated with direct-acting antiviral drugs. But there is a risk of reactivation of HBV during and after therapy. The rate of reactivation is lower in patients treated with direct-acting antiviral drugs as compared to those treated with peg interferon plus ribavirin. Biomarkers of HBV such as HBcrAg, HBV DNA and HBVpg RNA are not effective in the prediction of HBV reactivation; only the hepatitis B surface antigen titre can be used as a biomarker for HBV reactivation. HCV can also be reactive, but this is found in very rare cases in which HBV is present and is treated first.

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丙型肝炎病毒/乙型肝炎病毒合并感染:当前展望。
在流行地区,丙型肝炎病毒(HCV)/乙型肝炎病毒(HBV)合并感染很常见,合并感染的患者患肝细胞癌、肝纤维化和肝硬化等肝病的风险更高。在这种情况下,HCV占主导地位,并且HCV抑制HBV复制。HCV核心蛋白和被HCV激活的干扰素负责抑制HBV。HCV和HBV合并感染的患者也会出现免疫抑制。在HCV和HBV合并感染的患者中观察到HCV中和抗体反应和Th1样Tfh细胞循环的减少。两种病毒在肝脏中相互作用,由于两种病毒的相互作用,HCV/HBV合并感染的治疗是基于基因型的且复杂的。在HCV占优势的病例中,使用直接作用抗病毒药物和聚乙二醇干扰素加利巴韦林进行治疗,并持续监测AST和ALT。HBV占优势的患者不太常见,使用聚乙二醇干扰素和核苷类似物进行治疗,同时监测AST和ALT。用直接作用的抗病毒药物治疗,HCV-HBV合并感染的SVR率高于单一感染。但在治疗期间和治疗后存在HBV再激活的风险。与聚乙二醇干扰素加利巴韦林治疗的患者相比,直接作用抗病毒药物治疗的患者的再激活率较低。HBV的生物标志物如HBcrAg、HBVDNA和HBVpg RNA在预测HBV再激活方面无效;只有乙型肝炎表面抗原滴度可以用作HBV再激活的生物标志物。丙型肝炎病毒也可能是反应性的,但这是在非常罕见的情况下发现的,在这些情况下,乙型肝炎病毒是存在的,并首先进行治疗。
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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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