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Disease and treatment outcome in chronic active hepatitis C with occult HBV infection

Magda Berberova1, Antonia Mendizova, Elisaveta Popchristova

  • 1Clinic of Gastroenterology, Medical University Hospital Queen Joanna, 8 Bialo more str., Sofia 1527, Bulgaria. mberberova@yahoo.co.uk

Hepato-Gastroenterology
|December 31, 2003
PubMed

Insights

Patients with hepatitis C and occult hepatitis B showed less liver damage but a worse response to antiviral therapy. However, they had more frequent sustained normalization of liver enzymes.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Chronic active hepatitis C (HCV) can coexist with occult hepatitis B (HBV).
  • Understanding the clinical course and treatment response in these co-infected patients is crucial.

Purpose of the Study:

  • To evaluate the clinical course and antiviral treatment efficacy in chronic active hepatitis C patients with coexisting occult hepatitis B infection.

Main Methods:

  • 30 chronic active hepatitis C patients were treated with Interferon alpha-2b and Ribavirin for six months.
  • Patients were assessed for liver enzymes, histological activity, and virological response pre-treatment, post-treatment, and 6 months later.
  • 15 patients had positive hepatitis B core antibody (anti-HBc) indicating occult HBV infection.

Main Results:

  • The pure hepatitis C group exhibited higher biochemical and histological activity.
  • After treatment, the hepatitis C group showed 73% ALT normalization vs. 66% in anti-HBc positive patients.
  • HCV-RNA loss was observed in 47% of the hepatitis C group vs. 35% in anti-HBc positive patients, with sustained biochemical response rates of 28% vs. 40% respectively.

Conclusions:

  • Hepatitis B core antibody-positive patients may exhibit immune tolerance to HCV, leading to less liver damage.
  • Despite less advanced hepatolysis and necroinflammation, these patients showed a worse virological response to therapy.
  • Frequent sustained alanine aminotransferase (ALT) normalization was noted in the hepatitis B core antibody-positive group.
Abstract

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