Updates on the treatment and outcomes of dual chronic hepatitis C and B virus infection

Table 1 Proposed strategies for the treatment of patients positive for both anti-hepatitis C virus and hepatitis B surface antigen

HCV RNA	HBV activity	Treatment goals	Potential strategies	Level of evidence	Potential benefit of DAA-added therapy
Detectable	< 2000 IU/mL	Cure of HCV infection	P + R	Large multicenter trial	Increase rate of hepatitis C virus (HCV) sustained virologic response (SVR) in naïve or experienced patients
Detectable	≥ 2000 IU/mL	Cure of HCV infection and potentially control of HBV infection	P + R	Large multicenter trial	Increase rate of HCV SVR in naïve or experienced patients
Detectable	≥ 2000 IU/mL	Cure of HCV infection and control of HBV infection	P + R + NUC	Case report	Increase rate of HCV SVR in naïve or experienced patients
Detectable or undetectable	≥ 2000 IU/mL	Control of HBV infection	NUC	Small case-control study	Uncertain, wait for interferon-free regimen
Undetectable	≥ 2000 IU/mL	Control of HBV infection	P or NUC	Case report	None
Undetectable	< 2000 IU/mL	Not necessary	Clinical observation	No	None

P: Peginterferon; R: Ribavirin; NUC: Nucleos(t)ide analogue; DAA: Direct-acting antiviral.