Reham Samir Abouserie Ahmed  <br/><br/>
Risk of hepatitis B reactivation in a cohort of Egyptian patients with chronic hepatitis C treated with direct- acting antiviral drugs (DAAs) /  
 خطر اعادة تنشيط الالتهاب الكبدى بى فى مجموعة من المرضى المصريين المصابين بالالتهاب الكبدى سى المزمن والذين يخضعون للعلاج بالادوية المباشرة المضادة لفيروس سى 
Reham Samir Abouserie Ahmed ; Supervised Mohammed Salah Abdelbary , Naglaa Ali Hassan Zayed , Saeed Moustafa Elnahhas 
 - Cairo :   Reham Samir Abouserie Ahmed  ,   2020 
 - 157 , (10) P. :   charts , facimiles , maps ;   25cm  
<br/><br/>Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine  
<br/><br/> Background: Concerns about hepatitis B virus reactivation (HBVr) were raised with introduction of direct-acting antivirals (DAA) for hepatitis C virus (HCV) treatment. aim: Assessment of the risk of HBVr in chronic HCV patients during or after DAA treatment. methods: A cohort of 166 chronic HCV Egyptian patients treated with SOF-based DAA regimens and positive for HBcAb total was evaluated; ten were HBsAg-positive, while 156 had past HBV exposure (HBsAg-negative/HBcAb-positive). Laboratory investigations including HBV- DNA, liver stiffness measurements (LSM) by Transient elastography and Acoustic Radiation Forced Impulse (ARFI) together with serum markers of fibrosis; aspartate-aminotransferase-to-platelet-ratio index (APRI) and (FIB-4) were done before and after 12 weeks of DAA therapy. HBVr was assessed on and after DAA therapy. results: All HCV patients achieved SVR12 and exhibited significant decline of serum transaminases, bilirubin, APRI, LSM and CAP measurements after HCV eradication. Compared to HCV patients with past HBV infection; current HCV/HBV co-infected patients had significantly higher baseline AST and AFP. Virological HBVr was diagnosed in two patients with HBsAg-positive by  1 log10 IU/ml HBV-DNA levels, among whom one patient had clinical HBVr (>3 folds liver enzyme elevation) 12 weeks after DAA therapy, while none of HCV/past infected patients experienced HBVr.Patients with HBVr, had significantly higher baseline LSM compared to other patients. HCC was diagnosed in one cirrhotic HBsAg-positive patient after stoppage of DAA therapy. conclusion: HBVr was evident among HCV with current HBV co-infection following DAA therapy while past HBV infection does not seem to be a predisposing condition to HBVr 
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<br/><br/><label>Subjects--Index Terms: </label>Direct acting anti-viral (DAAs) HBV reactivation  Hepatitis B virus (HBV)