Lack of studies showing the risk of HBV reactivation in patients treated with direct acting antivirals (DAAs) for hepatitis C virus. Eleven patients among 158 were positive for HBV who received direct-acting antivirals (DAAs) in various hospitals of Punjab, Pakistan. The reactivation of HBV established when viral DNA level ≥100 IU/mL in serum and higher ALT level was set as 2 times increase in normal level. The others parameters like Hemoglobin, White Blood Cells and Platelets were monitored respectively. The sofosbuvir/daclatasvir based therapy was used in seven cases while sofosbuvir/ ledipasvir in four cases. When reactivation of HBV occurred in these cases, although the effective response initially noted against HCV but no response at later stage, it led to death in four patients. The variation of ALT level showed the reactivation of HBV in these cases. When no sufficient response with DAAs was achieved in HCV patients, there would be reactivation of hepatitis B virus that is a major health concern.

Index Terms- Alanine aminotransferase, Direct Acting Antivirals, Hepatitis B virus, Hepatitis C virus