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Abstract
We report the case of a 60 year old gentleman referred for management of dually active chronic hepatitis B (HBV) and C (HCV) co-infection. Initial treatment with Pegylated Interferon and Ribavirin was marked by early virological response for HCV as from week 12 with sustained high virological response to the end of treatment at week 48. There was however a non-response of the HBV to this peg interferon and Ribavirin and the introduction of a nucleoside analogue (Tenofovir) at the end of Peg interferon Ribavirin treatment at week 48 resulted in remarkable HBV suppression to undetectable HBV-DNA levels. While this case report demonstrates that HBV/HCV co-infection can be satisfactorily treated in our setting, the high prevalence of both viral infections in Cameroon, the high cost of management and the unavailability of appropriate drugs warrants the Ministry of Public Health to take the lead in implementing adequate preventive and therapeutic strategies so as to reduce morbidity and mortality of liver diseases associated with these infections.
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References
- Crockett SD and Keeffe EB, Natural history and treatment of hepatitis B virus and hepatitis C virus coinfection. Annals of clinical microbiology and antimicrobials, 2005. 4: p. 13.
- Yalcin K, Degertekin H, Yildiz F, and Kilinc N, A severe hepatitis flare in an HBV-HCV coinfected patient during combination therapy with alpha-interferon and ribavirin. Journal of gastroenterology, 2003. 38(8): p. 796-800.
- Fattovich G, Tagger A, Brollo L, Giustina G, Pontisso P, Realdi G, Alberti A, and Ruol A, Hepatitis C virus infection in chronic hepatitis B virus carriers. The Journal of infectious diseases, 1991. 163(2): p. 400-2.
- Zarski JP, Bohn B, Bastie A, Pawlotsky JM, Baud M, Bost-Bezeaux F, Tran van Nhieu J, Seigneurin JM, Buffet C, and Dhumeaux D, Characteristics of patients with dual infection by hepatitis B and C viruses. Journal of hepatology, 1998. 28(1): p. 27-33.
- Chu CJ and Lee SD, Hepatitis B virus/hepatitis C virus coinfection: epidemiology, clinical features, viral interactions and treatment. Journal of gastroenterology and hepatology, 2008. 23(4): p. 512-20.
- Global burden of disease (GBD) for hepatitis C. Journal of clinical pharmacology, 2004. 44(1): p. 20-9.
- Cameroon National Tuberculosis Strategic plan 2010-2014. 2011 [cited 201 24 June]; Available from: http://dev.cdnss.dros-minsante-cameroun.org/sites/dev.cdnss.dros-minsante-cameroun.org/files/biblio/2011/nationaltuberculosisstrategicplan2010.pdf.
- Lok AS and McMahon BJ, Chronic hepatitis B: update 2009. Hepatology, 2009. 50(3): p. 661-2.
- Nwokediuko SC, Chronic hepatitis B: management challenges in resource-poor countries. Hepatitis monthly, 2011. 11(10): p. 786-93.
References
Crockett SD and Keeffe EB, Natural history and treatment of hepatitis B virus and hepatitis C virus coinfection. Annals of clinical microbiology and antimicrobials, 2005. 4: p. 13.
Yalcin K, Degertekin H, Yildiz F, and Kilinc N, A severe hepatitis flare in an HBV-HCV coinfected patient during combination therapy with alpha-interferon and ribavirin. Journal of gastroenterology, 2003. 38(8): p. 796-800.
Fattovich G, Tagger A, Brollo L, Giustina G, Pontisso P, Realdi G, Alberti A, and Ruol A, Hepatitis C virus infection in chronic hepatitis B virus carriers. The Journal of infectious diseases, 1991. 163(2): p. 400-2.
Zarski JP, Bohn B, Bastie A, Pawlotsky JM, Baud M, Bost-Bezeaux F, Tran van Nhieu J, Seigneurin JM, Buffet C, and Dhumeaux D, Characteristics of patients with dual infection by hepatitis B and C viruses. Journal of hepatology, 1998. 28(1): p. 27-33.
Chu CJ and Lee SD, Hepatitis B virus/hepatitis C virus coinfection: epidemiology, clinical features, viral interactions and treatment. Journal of gastroenterology and hepatology, 2008. 23(4): p. 512-20.
Global burden of disease (GBD) for hepatitis C. Journal of clinical pharmacology, 2004. 44(1): p. 20-9.
Cameroon National Tuberculosis Strategic plan 2010-2014. 2011 [cited 201 24 June]; Available from: http://dev.cdnss.dros-minsante-cameroun.org/sites/dev.cdnss.dros-minsante-cameroun.org/files/biblio/2011/nationaltuberculosisstrategicplan2010.pdf.
Lok AS and McMahon BJ, Chronic hepatitis B: update 2009. Hepatology, 2009. 50(3): p. 661-2.
Nwokediuko SC, Chronic hepatitis B: management challenges in resource-poor countries. Hepatitis monthly, 2011. 11(10): p. 786-93.