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Direct-acting Antiviral (DAA) treatment for Hepatitis C risks Hepatitis B reactivation

New guidance from the Medicines and Healthcare products Regulatory Agency (MHRA) advises that all hepatitis C patients should be screened for hepatitis B before starting treatment with new Direct-acting Antivirals (DAAs).

If patients are infected with both viruses this does not preclude treatment but this should be monitored and managed. This is due to the possibility that rapid reduction in hepatitis C viral load during treatment with DAAs may lead to increased replication of hepatitis B virus in co-infected patients.

The guidance states that all patients should be screened for hepatitis B before starting treatment for chronic hepatitis C with direct-acting antiviral interferon-free regimens.

We strongly recommend that all members who are on or starting treatment for their Hepatitis C should be screened for Hepatitis B. You should also advise your doctor or pharmacist if you have or suspect you have a current or previous infection with Hepatitis B and will be more closely monitored.

The MHRA guidance follows similar warnings from the US Food and Drug Administration and the European Medicines Agency.

Patients who are receiving Vitamin K antagonists such as Warfarin are also advised to inform their doctor and may need to have more-regular blood tests to check how well their blood can clot.

Liz Carroll

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