DAAs and HBV coinfection

Hepatitis B (HBV) reactivation can be a rare but serious problem during DAA treatment. 

HBV that was previously resolved or dormant can flare-up, which can lead to liver failure that in very rare cases could be fatal. HBV testing is therefore recommended before starting DAAs. 

Even though most HIV positive people in the UK are likely to be on treatment for both HIV and HBV, close HBV monitoring is needed during HCV treatment. 

With HBV/HCV coinfection, one virus suppresses the other, with HCV usually suppressing HBV. DAAs cause a rapid drop in HCV viral load which can let HBV reactivate. 

Last updated: 1 November 2024.