Poor Response to Treatment with Peg-IFN Containing Regimens in Patients Coinfected with Hepatitis B and Hepatitis C Virus

To investigate the clinical charcteristics and treatment response of patients with chroniccoinfection of hepatitis b virus (hbv) and hepatitis c virus (hcv).methods: the study included nine consecutive patients with chronic hbv/hcv coinfection. diagnosis was performed byliver biopsy and/or clinical and laboratory evaluation. six patients received 48 weeks of pegylated interferon (peg-ifn)monotherapy or combination therapy with peg-ifn plus ribavirin according to the dominant virus.results: the dominant infection was hepatitis c in six cases. of the four patients who completed the treatment andfollow-up period, only one had a sustained viral response (svr) to hcv, but unfortunately, this was accompanied by areactivation of hbv-dna without flaring of hepatitis. no patient had an hbv-dna response. another two patients arestill in the follow-up period. one of these patients had an undetectable level of hcv-rna, and the other had anundetectable level of hbv-dna at baseline. at the end of treatment, both hbv-dna and hcv-rna were negative inthese patients. the hbv-dna-negative patient showed a transient hbv-dna positivity after clearance of hcv-rna.conclusions: in the majority of hbv/hcv coinfected cases in our sample, hcv was the dominant virus. currently, thestandard treatment regimens are not effective for clearance of hbv and/or hcv. hcv clearance may induce hbvreactivation without flaring of hepatitis.