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Review

Hepatitis C Virus and Hepatitis B Virus Co-Infection

by 1 and 2,3,4,*
1
Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei 112, Taiwan
2
Hepatitis Research Center, National Taiwan University Hospital, Taipei 100, Taiwan
3
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
4
Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei 100, Taiwan
*
Author to whom correspondence should be addressed.
Viruses 2020, 12(7), 741; https://doi.org/10.3390/v12070741
Received: 6 June 2020 / Revised: 28 June 2020 / Accepted: 8 July 2020 / Published: 10 July 2020
(This article belongs to the Special Issue Viral Coinfection)
Hepatitis C virus (HCV) and hepatitis B virus (HBV) co-infection can be encountered in either virus endemic countries. Co-infection can also be found in populations at risk of parenteral transmission. Previous studies demonstrated a high risk of liver disease progression in patients with HCV/HBV co-infection; thus, they should be treated aggressively. Previous evidence recommended therapy combining peginterferon (pegIFN) alfa and ribavirin for co-infected patients with positive HCV RNA. Recent trials further advise using direct-acting antivirals (DAAs) for the clearance of HCV in the co-infected patients. Reactivation of HBV has been observed in patients post-intervention, with higher risks and earlier onset in those having had HCV cured by DAA- versus pegIFN-based therapy. The mechanism of HBV reactivation is an interesting but unsolved puzzle. Our recent study revealed that in vitro HBV replication was suppressed by HCV co-infection; HBV suppression was attenuated when interferon signaling was blocked. In vivo, the HBV viremia, initially suppressed by the presence of HCV super-infection, rebounded following HCV clearance by DAA treatment and was accompanied by a reduced hepatic interferon response. In summary, major achievements in the treatment of HCV/HBV co-infection have been accomplished over the past 20 years. Future clinical trials should address measures to reduce or prevent HBV reactivation post HCV cure. View Full-Text
Keywords: co-infection; hepatitis B virus; hepatitis C virus; pegylated interferon; direct-acting antivirals; reactivation co-infection; hepatitis B virus; hepatitis C virus; pegylated interferon; direct-acting antivirals; reactivation
MDPI and ACS Style

Shih, Y.-F.; Liu, C.-J. Hepatitis C Virus and Hepatitis B Virus Co-Infection. Viruses 2020, 12, 741. https://doi.org/10.3390/v12070741

AMA Style

Shih Y-F, Liu C-J. Hepatitis C Virus and Hepatitis B Virus Co-Infection. Viruses. 2020; 12(7):741. https://doi.org/10.3390/v12070741

Chicago/Turabian Style

Shih, Yi-Fen, and Chun-Jen Liu. 2020. "Hepatitis C Virus and Hepatitis B Virus Co-Infection" Viruses 12, no. 7: 741. https://doi.org/10.3390/v12070741

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