Interferon plus ribavirin therapy for coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV)

Abstract

Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) produces a higher incidence of cirrhosis and HCC development compared to monoinfection with either virus alone and therefore, aggressive treatment is preferred. Recently, pegylated interferon alpha plus ribavirin therapy was recommended as the treatment, but the information is not enough. We performed interferon plus ribavirin therapy for two cases of coinfection with HBV and HCV. In a case of HBe-Ag negative, a sustained virologic response (SVR) for HCV was achieved and HBs-Ag became negative. In the other case involving HBe-Ag positive, although SVR for HCV was achieved, severe hepatitis and liver fibrosis occurred due to rise of HBV activity during clearance of HCV, which was improved by adding nucleoside analogs. Treatment of coinfection with HBV and HCV should be selected after determine which virus is dominant. In some cases, the use of nucleoside analogs should be considered.