Evolution of qHBsAg levels in HBV/HCV co-infected patients with low serum HBV DNA: Comparison between treated versus untreated.

Background And Aims: Patients with chronic hepatitis B virus (HBV) infection and low serum HBV DNA level (<2000 IU/mL) are not indicated for anti-HBV therapy. Fortunately, anti-HBV therapy is recommended if co-infected with hepatitis C virus (HCV) by World Health Organization recently. Whether specific anti-viral therapy could facilitate the decline or the loss of hepatitis B surface antigen (HBsAg) in this clinical setting was investigated in the co-infected patients.

Methods: We retrospectively collected 60 patients with chronic HBV/HCV co-infection and low serum HBV DNA (<2000 IU/mL). All were positive for HBsAg and anti-HCV/HCV RNA >6 months. Among them, 26 patients didn't receive any anti-HBV or anti-HCV therapy (Group 1), 23 patients received peginterferon plus ribavirin therapy for HCV (Group 2) and 11 patients received DAA therapy for HCV (Group 3). Serum HBsAg levels at the end of 3-year follow-up was obtained retrospectively.

Results: Serum HBsAg (log10 IU/mL) decline was found to be greatest in Group 2 patients, [median: log 0.605; Range 25 %-75 % [Range] = 0.272-1.476) and least in Group 3 patients, (log 0.340, -0.453-0.559). Statistically significant difference was found between Group 2 and 3 (P = 0.0489). Proportion of patient with >1 log decline in serum HBsAg was 26.9 %, 43.4 % and 9.1 % in Group 1, 2 and 3, respectively. Statistically significant difference was also found between Group 2 and 3 (P = 0.045).

Conclusions: In HBV/HCV co-infected patients with low serum HBV DNA, favorable HBsAg dynamics was found post-interferon/ribavirin therapy. These findings supported further investigations of interferon-based therapy in this clinical setting.