Evidence map›Paper›PMID 37022602›Full record

ArticleDigestive diseases and sciences2023

Low Rate of Hepatitis B Reactivation Among Patients with Chronic Hepatitis C During Direct Acting Antiviral Therapy.

Nehna Abdul Majeed, Ahmad Samer Alawad, Kin Seng Liem, Varun Takyar, Harvey Alter, Jordan J Feld, Harry L A Janssen, Marc G Ghany

Abstract read
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In one paragraph

Article in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Clinical and demographic characteristics of participants in a hepatitis C treatment trial in rural Kentucky: How policies around treatment access may impact elimination efforts in the United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Nehna Abdul MajeedLiver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Ahmad Samer AlawadLiver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Kin Seng LiemToronto Centre for Liver Disease, Toronto General Hospital, Toronto, Canada.
Varun TakyarDepartment of Gastroenterology, Alta Bates Summit Medical Center, Oakland, CA, USA.
Harvey AlterTransfusion Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Jordan J FeldToronto Centre for Liver Disease, Toronto General Hospital, Toronto, Canada.
Harry L A JanssenToronto Centre for Liver Disease, Toronto General Hospital, Toronto, Canada.
Marc G GhanyLiver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. marcg@intra.niddk.nih.gov.ORCID 0000-0003-2837-0188
National Institutes of Health · USUniversity of Toronto · CAAlta Bates Summit Medical Center · USNational Institutes of Health Clinical Center · US

Funding

Natural History, Therapy and Pathogenesis of Chronic Viral Hepatitis CZIADK075009 · NIDDK · NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES · PI GHANY, MARC · 2009 to 2025
$7.2M
6 · The paper itself

Abstract

BACKGROUND AND

aimsHepatitis B virus (HBV) reactivation has been reported in patients co-infected with hepatitis C virus (HCV) during direct acting antiviral (DAA) therapy, leading the United States Food and Drug Administration (U.S. FDA) to issue a black box warning on all DAA drug labels recommending monitoring for HBV reactivation. We conducted a comprehensive evaluation to assess the rate of HBV reactivation among patients with chronic hepatitis C (CHC) during DAA therapy.

methodsPatients with CHC and recovered HBV infection (hepatitis B surface antigen negative (HBsAg)/anti-hepatitis B core positive), treated with DAAs were included if stored sera were available. Samples were tested for HBV DNA, HBsAg, and ALT. HBV reactivation was considered if (1) HBV DNA was undetectable pre-DAA therapy and became detectable post-therapy, or (2) HBV DNA was detectable pre-treatment, but not quantifiable (< 20 IU/mL) and became quantifiable post-treatment.

result79 patients with median age of 62 years were included. 68% were male and Caucasian. Various DAA regimens were administered for 12-24 weeks. Reactivation occurred in 8/79 (10%) of patients and occurred more frequently in men compared to women: 6 during treatment and 2 after treatment. Neither an ALT flare nor HBsAg seroreversion were observed. Detectable HBV DNA was transient in 5/8 and could not be determined in 3/8 but ALT flares were not observed in follow-up of these patients.

conclusionThe risk of HBV reactivation was low in CHC patients with resolved HBV during DAA therapy. Our data support testing for HBV DNA only in selected patients with ALT flares or failure of ALT normalization during DAA treatment.

Indexed as

Hepatitis BHepatitis B, ChronicHepatitis CHepatitis C, ChronicAntiviral AgentsDNA, ViralFemaleHepatitis B Surface AntigensHepatitis B virusHumansMaleMiddle AgedVirus ActivationAntiviral AgentsDNA, ViralHepatitis B Surface AntigensALT flareDirect acting antiviralsHBV DNA monitoringHepatitis B reactivationResolved Hepatitis B

Identifiers

PMID37022602
OpenAlexW4362657187

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.