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Concurrent hepatitis C virus and hepatitis delta virus superinfection in patients with chronic hepatitis B virus
Insights
Concurrent hepatitis C virus (HCV) and hepatitis D virus (HDV) infections occur in patients with chronic hepatitis B virus (HBV) infection. In these triple infections, HCV may transiently suppress HDV and HBV.
Area of Science:
- Hepatology
- Virology
- Immunopathology
Background:
- Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) share similar transmission routes.
- Coinfection with multiple hepatitis viruses can occur in patients with chronic HBV infection.
Purpose of the Study:
- To investigate the occurrence of concurrent HCV and HDV infections in patients with chronic HBV.
- To examine the clinicohistological and immunopathological features of these multiple hepatitis virus infections.
Main Methods:
- Enzyme immunoassay was used to detect anti-HCV antibodies in serum specimens from 86 patients with acute HDV superinfection.
- Immunopathological studies assessed the presence of hepatitis B core antigen (HBcAg) and HDV antigen (HDAg).
Main Results:
- 18.2% of patients with acute HDV superinfection were coinfected with HCV.
- Patients with HCV coinfection were older than those without.
- HCV coinfection was associated with decreased detection of HBcAg and HDAg compared to patients without HCV.
Conclusions:
- Concurrent HCV and HDV superinfections are possible in patients with chronic HBV infection.
- HCV may transiently suppress HDV and HBV replication during triple viral infections.
Abstract:
Since hepatitis C virus (HCV) and hepatitis delta virus (HDV) are transmitted by the same routes as hepatitis B virus (HBV), simultaneous or concurrent HCV and HDV infection in patients with chronic HBV infection may occur. To test this hypothesis and to examine the clinicohistological and immunopathological presentations of such multiple hepatitis virus infections, acute and/or convalescent serum specimens from 86 patients with acute HDV superinfection were tested by enzyme immunoassay for antibodies to HCV. Of the 86 patients, 18 (20.9%) were associated with HCV infection. Although patients with early mortality cannot be evaluated by the HCV markers used in this study, the results showed that the clinical and histologic features were similar except that patients with HCV infection were older than those without HCV infection (P less than 0.01). Immunopathological studies carried out within 2 months after the onset of acute HDV superinfection demonstrated that hepatitis B core antigen (HBcAg) was not detected in any patient and HDV antigen was detected in 18.2% of the patients with HCV infection whereas HBcAg and HDAg were found in 7% and 65.1%, respectively, of those without HCV coinfection (P less than 0.02). It is concluded that concurrent HCV and HDV superinfections can and do occur in patients with chronic HBV infection. In these triple viral infections, HCV may even transiently suppress HDV and HBV.