BACKGROUND/AIMS: To evaluate the efficacy of Direct Antiviral Agents (DAA)-based regimen in HBsAg/anti-HCV/HCV-RNA-positive patients (pts) in terms of sustained virolgical response for HCV and of reactivation of HBV infection.
METHODS: In a multicentric, prospective study we enrolled 29HBsAg/anti-HCV-positive pts treated with DAA . At the time when DAA was started, 16 pts were treatedwith NUCfrom 0-216 months (NUC-tx group) and 13 pts not (NUC-sparing group); in this last group, HBV-DNA was negative in 11 and positive in 2 (230 and 570 IU/ml).All patients were monitored for HCV-RNA and HBV-DNA every month during the treatment and for 6 months after the stop.
RESULT. Of the 29 patients enrolled, 27 (93.1%) showed a HCV-SVR and 2 a relapse. In NUC-tx group, no patient showed a HBV virological reactivation. Of the 13pts in NUC-sparing group, 8 pts remained HBV-DNA negative during observation and 5 showed a HBV reactivation (2 at month 1 of DAA treatment, one at month 4, one at month 3 and one at the stop of DAA); Comparing the characteristics of the 5 patients with virological HBV reactivation to the 24 without, the former were more frequently without NUC treatment (0 vs. 66.6%, p=0.02).
Conclusion: DAA treatment is efficacious also in HBsAg positive patient. However, probably because of the known reciprocal viral interaction, HBV reactivation after the negativization of HCV is possible in the pts not treated with NUC.

margherita macera
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