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Abstract: Objective To analyze the epidemiological characteristics of hepatitis B virus
(HBV) / hepatitis C virus (HCV) co-infection and the occurrence and prognosis of HBV
reactivation rate after direct-acting antiviral agents (DAA) therapy. Methods Patients with
HCV/HBV co-infection and receiving anti-HCV treatment in Beijing Ditan Hospital, Capital
Medical University from October 2008 to May 2020 were retrospectively enrolled. The
route of infection and the presence of cirrhosis and hepatocellular carcinoma (HCC) were
analyzed. Hepatitis B virus surface antigen (HBsAg), alanine transminase (ALT), aspirate
transaminase (AST), total bilirubin (TBil), direct bilirubin (DBil)and albumin (ALB) before
and after treatment were compared. The effcacy and HBV reactivation after DAA treatment
were analyzed. Results The sustained virological response (SVR) rate of DAA was 94.44%
(17/18) in patients with HBV/HCV co-infection. After 12 weeks of DAA treatment, the level
of ALT (median: 15.30 U/L vs 57.55 U/L) and AST (median: 18.10 U/L vs 71.10 U/L) decreased
significantly than those on baseline (all P ＜ 0.05). At 12 weeks after antiviral treatment
of DAA, the level of ALT (median: 17.75 U/L vs 57.55 U/L), AST (median: 22.25 U/L vs
71.10 U/L) and DBil (median: 4.60 μmol/L vs 5.70 μmol/L) decreased significantly and
ALB (median: 45.80 g/L vs 38.00 g/L) increased significantly than those on baseline (all
P ＜ 0.05). A total of 2 patients (2/14, 14.29%) experienced HBV reactivation after DAA anti-HCV
therapy which occurred 4～5 weeks (38 days) after the end of antiviral treatment. The SVR rate of
co-infected patients with liver cirrhosis and HCC were 100% (8/8), and 75.00% (3/4), respectively.
Conclusions DAA has considerable antiviral effcacy in the treatment of HBV/HCV co-infection.
Patients with liver cirrhosis or HCC are more likely to occur HBV reactivation. Close monitoring of
HBV before, during and after DAA anti-HCV treatment is essential.
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