HCV patients on DAAs need hepatitis B testing
All patients beginning hepatitis C virus (HCV) treatment with direct-acting antiviral (DAA) therapy should be tested for hepatitis B virus (HBV).
The recommendation, by a guidance panel of the American Association for the Study of Liver Diseases (AASLD) / Infectious Diseases Society of America, for HBV serologic testing for all patients with HCV infection is not a new recommendation, however.
“The Guidance Panel has highlighted this long-standing recommendation by moving the recommendation into a box due to the recent reports of HBV flare/reactivation in the setting of DAA therapy, suggesting that serologic testing for HBV is not being completed as routinely as it should be,” Susanna Naggie, MD, co-chair of the HCV Guidance Panel and associate professor of medicine at Duke University, told Medical Economics.
“The recommendation is more about ensuring that providers are aware of the patient’s concomitant HBV status, due to the fact that some of the patients may already meet criteria for HBV therapy, or to at a minimum recognize the co-infection in the case that liver enzyme levels change during the course of HCV therapy or after.”
Immune active HBV infection requires immediate medical attention regarding therapy, and immune inactive HBV infection requires monitoring due to the transition from immune inactive to immune active disease, she said.