J Hepatol. 2008 Apr 29. [Epub ahead of print]
The HEP-NET B/C co-infection trial: A prospective multicenter study to
investigate the efficacy of pegylated interferon-alpha2b and ribavirin in
patients with HBV/HCV co-infection.
Potthoff A, Wedemeyer H, Boecher WO, Berg T, Zeuzem S, Arnold J, Spengler U,
Gruengreiff K, Kaeser T, Schuchmann M, Bergk A, Forestier N, Deterding K,
Manns MP, Trautwein C; for the Hep-Net B/C Co-infection Study Group.
Department of Gastroenterology, Hepatology and Endocrinology, Medizinische
Hochschule Hannover, Carl-Neuberg-Str. 1, 30623 Hannover, Germany.
BACKGROUND/AIMS: The efficacy of pegylated interferon alpha and ribavirin in
HBV/HCV co-infected patients is unknown. METHODS: Nineteen patients with
chronic HBV/HCV co-infection (HBsAg and HCV-RNA positive; 10 HCV-genotype 1; 9
HCV-genotype 2 or 3) were included in this prospective multicenter pilot
study. Baseline HBV-DNA was negative in 13 individuals. All patients received
weight-adjusted PEG-IFN-alpha2b and ribavirin for 48 weeks. RESULTS: In the
intent-to-treat analysis, a biochemical and an HCV-RNA response were observed
in 12 and 14 patients, respectively (63% and 74%). At the end of the treatment
as well as at the end of the follow-up the HCV-RNA response was 93% (14/15) in
patients adherent to therapy (86% in genotype 1 and 100% in genotypes 2 and 3
infection). Two of the five initially HBV-DNA positive patients with follow-up
available were HBV-DNA negative at follow-up week 24. In contrast, HBV-DNA
became detectable after the clearance of HCV in four initially HBV-DNA
negative patients. CONCLUSIONS: Combination therapy with PEG-IFN-a2b and
ribavirin is highly effective in inducing a virological response concerning
HCV in patients with HBV/HCV co-infection. However, HBV replication may
increase after the clearance of HCV and thus close monitoring for both the
viruses is recommended even in patients with initially undetectable HBV-DNA.