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Author Topic: DAAs found to reactivate HBV in current or prior hbv infectees  (Read 9272 times)

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Offline dragonslayer

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DAAs found to reactivate HBV in current or prior hbv infectees
« on: October 05, 2016, 12:59:14 pm »
FDA Warns Against Hepatitis B Reactivation In Some Patients Taking Direct-Acting Hepatitis C Antivirals


http://www.fda.gov/Drugs/DrugSafety/ucm522932.htm


Scary.
« Last Edit: October 05, 2016, 01:01:29 pm by dragonslayer »
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

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Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #1 on: October 10, 2016, 12:59:17 am »
Saw that they are adding black box warnings to DAA's
So glad I was not co-infected with hep b but very concerning for those that are
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline MommaT

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  • Tomorrow Is a New Day
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #2 on: October 10, 2016, 08:41:02 am »
Hi Lynn and Dragonslayer,

I saw this come up-so do you agree -it is true. DAA can bring Hep B back. What does this say about compromised immunity in other areas? What will we do about it? Was I better off waiting even longer? I waited for a better Med but maybe DAA is not good for you.

It is a crap shoot-and Maybe they priced high for future lawsuits.
62 year old Female
Treatment Naive
Genotype 2b
2001 Dx Donated blood after 9/11
2002 Biopsy F1
2016 Fibroscan 15 F4
Comp Cirrhosis Stage 1
pretreatment VL 1,722.660 mil
platelets 122 low
alpha 2 Macroglobulins 647
Apolipoprotein A-1 214
GGT 67 high
AFP Serum Tumor Marker 11.4
ALT 563 AST 332
2016 Sept 16 Epclusa started
4 wk VL <15 HCV Detecte
ALT 19 AST 18
8 wk VL HCV Undetected!
12/8/16 EOT Yipee!
12 wk VL HCV Undetected
SVR 12
SVR  24  10/5/2018 HCV Undetected   12/10/18 DETECTED????????

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #3 on: October 10, 2016, 11:54:13 am »
All this says from the FDA is that those who were co-infected with hep c and hep b whose hep b was inactive there is a risk their hep b could he activate.

This says nothing else about anything except the risk of hep b reactivation.

Personally I had to treat no matter what Harvoni has saved my life.
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Gaj

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  • Posts: 172
  • Optimist
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #4 on: October 10, 2016, 08:41:34 pm »
I responded about this in another thread. Here is the link.

http://forums.hepmag.com/index.php?topic=4494.msg46077#msg46077


If you are in the small group with chronic/dormant/inactive HBV then you should discuss the slight risk vs benefit of HCV treatment with your doctor or specialist.
Male - 61 years
Genotype 3a (since 1978?)
Diagnosed 2012
Treated 2013 PEG/Riba/Dac (Relapsed)
F4 - HCC#1 Resected 06/15 - #2 RFAblated 11/15
11/18/15 Commenced Generic Tx - Sof/Dac/Riba (24wks)
Pre Tx = ALT: 270  AST: 209  ALB: 31
05/05/16 = ALT: 34  AST: 32  ALB: 40  VL: Undetected (EOT)
06/16/16 = Relapsed
06/23/16 = ALT: 92  AST: 59  ALB: 40  VL: 290,770
01/12/17 3rd Tx - Zepatier + Sofosbuvir (16wks)
05/03/17 EOT und
06/22/17 SVR7 und
07/27/17 SVR12 UND!
10/26/17 SVR24 UND & Cured!!!

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #5 on: October 10, 2016, 08:48:32 pm »
Just to add MommaT if you never had hep B this is not an issue for you
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline MommaT

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  • Posts: 65
  • Tomorrow Is a New Day
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #6 on: October 12, 2016, 12:30:55 pm »
Thank you Lynn-

So, you think i am okay?  I tested on labwork positive for Hep A -negative for Hep B then had Vaccine 2015. Before starting treatment the labwork shows again Positive Hep A but again negative to Hep B.

 I look back I had only 2 vaccine shots and maybe needed 3? I thought i needed the Hep B vaccine before treatment? I am so confused.

I think Hep B is serious to get so that is why I got the vaccine to begin with.
Thanks-Lynn you certainly help so many on this site!

62 year old Female
Treatment Naive
Genotype 2b
2001 Dx Donated blood after 9/11
2002 Biopsy F1
2016 Fibroscan 15 F4
Comp Cirrhosis Stage 1
pretreatment VL 1,722.660 mil
platelets 122 low
alpha 2 Macroglobulins 647
Apolipoprotein A-1 214
GGT 67 high
AFP Serum Tumor Marker 11.4
ALT 563 AST 332
2016 Sept 16 Epclusa started
4 wk VL <15 HCV Detecte
ALT 19 AST 18
8 wk VL HCV Undetected!
12/8/16 EOT Yipee!
12 wk VL HCV Undetected
SVR 12
SVR  24  10/5/2018 HCV Undetected   12/10/18 DETECTED????????

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #7 on: October 12, 2016, 12:52:12 pm »
You are fine as far as this new concern about hepatitis B reactivation.

I would ask your doctor about hepatitis B vaccination. I think I remember I had to do three shots for the series but in any event you never had hepatitis B so you can't reactivate what you never had.
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Pete

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  • Posts: 110
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #8 on: November 13, 2016, 07:14:33 pm »
Hello everyone - I've been dormant from the forum for awhile and just read this. 

I tested reactive for HBV core AB  years ago. A follow up test one month later indicated non-reactive for HBV AB.  My doctor at the time presumed the first result was a false positive.  I was never checked again for HBV. I dropped a note to my current doctor requesting an order for the HBV testing be added to my next set of lab tests. 

You just can't take you eye off the ball with this business.  Thanking everyone again for keeping the information current.

Pete

Offline Lynn K

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  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #9 on: November 13, 2016, 07:21:57 pm »
Hi Pete

Did you ever have hep b? Did you ever test positive for hep b virus or just an antibody test? As I understand this as long as you were never infected with hep b you should be in the clear but of course better to be sure
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Pete

  • Member
  • Posts: 110
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #10 on: November 14, 2016, 01:37:31 am »
Well, not that I was aware of at the time.  Here's what the test states from 2002.

Hepatitis B  Surface Antigen - Non-Reactive
Hepatitis B Core Antibody -     Reactive
Hepatitis B Surface Antibody QL - Borderline

One month later only the Core HBV AB was checked and was non-reactive.  So  maybe, maybe not... who can tell for sure with conflicting test results from back in the day.  I think it best not to leave anything to chance and have the test done. 

Thanks for asking,  I provide an update when I know more.   

Offline Lynn K

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  • Member
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  • Get tested, get treated, get cured, fight Hep c!
Re: DAAs found to reactivate HBV in current or prior hbv infectees
« Reply #11 on: November 14, 2016, 01:42:14 am »
All I know about hep b testing is that results are difficult for laypersons to interpret so best left up to the professionals for sure

I think you are probably in the clear please let us know what you learn about all this
Good luck
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

 


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