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High Frequency of Hepatitis B Core and Surface Antibodies in Hepatitis C Virus-Infected Patients on the Screening
Insights
Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection is common in endemic areas. Screening HCV antibody-positive patients revealed HBV reactivation risks, necessitating HBsAb and HBcAb testing, especially before immunosuppressive therapy.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of chronic liver disease and hepatocellular carcinoma.
- HBV and HCV co-infection is prevalent in regions where both viruses are endemic.
- Understanding HBV co-infection characteristics in HCV antibody-positive patients is crucial for effective management.
Purpose of the Study:
- To analyze the characteristics of HBV co-infection among Japanese patients who tested positive for HCV antibody during screening.
- To assess the prevalence of HBV markers (HBsAb, HBcAb, HBV-DNA, HBcrAg) in HCV antibody-positive individuals.
- To evaluate the correlation between HCV antibody titer, HCV-RNA status, and liver enzyme levels.
Main Methods:
- Screening of 12,582 patients for HCV antibody (HCVAb) status between January and December 2011.
- Serological testing for HBsAb and HBcAb in 331 HCVAb-positive/HBsAg-negative patients.
- Detection of HCV-RNA, HBV-DNA, and HBcrAg in available residual serum samples.
Main Results:
- HCVAb was positive in 3.2% of patients (402/12,582).
- HCV-RNA was detected in 79.0% of patients, with higher prevalence in high HCVAb titer groups.
- HBsAb and HBcAb positivity rates were 18.4% and 30.5%, respectively. HBV-DNA and HBcrAg were detected in 2.8% and 1.9% of patients, respectively.
- Abnormal ALT levels were observed in 44.6% of HCVAb-positive patients, more frequent in high HCVAb titer and HCV-RNA positive groups.
Conclusions:
- HBV reactivation is a significant concern in HCVAb-positive/HBsAg-negative patients, particularly those undergoing chemotherapy or immunosuppressive therapy.
- Simultaneous testing for HBsAb and HBcAb is recommended for comprehensive HBV screening in this population.
- Early detection and monitoring are essential to prevent HBV-related complications.
Background:
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are important human pathogens that cause chronic liver disease and hepatocellular carcinoma. Co-infection of HBV and HCV is not uncommon, particularly in countries where these two viruses are endemic. Therefore, the characteristics of HBV co-infection in HCV antibody (HCVAb) -positive Japanese patients found on the screening examination were analyzed.
Patients And Methods:
Between January and December 2011, HCVAb status was evaluated as the screening examination in 12,582 patients in Gunma University Hospital, and it was positive in 402 patients (3.2%). In 331 HCVAb-positive/HBs antigen (HBsAg) -negative patients with available residual serum, HBs antibody (HBsAb) and HBc antibody (HBcAb) were examined. In addition, HCV-RNA was examined in 291 patients with available residual serum. HBV-DNA and HBV core-related antigen (HBcrAg) were examined in 106 patients with available residual serum.
Results:
The HCVAb titer was distributed between 1 and 18 sample/cutoff index (S/CO). 275 patients (83.1%) had a high HCVAb titer (S/CO ≥10). HCV-RNA was positive in 230 (79.0%) patients, and it was more frequently detected in HCVAb high-titer patients (88%) than in low-titer patients (32%; p < 0.0001); 61 (18.4%) and 101(30.5%) patients were positive for HBsAb and HBcAb, respectively. Of 230 HCV-RNA-positive patients, 38 (16.5%) and 59 (25.6%) were positive for HBsAb and HBcAb, respectively. Three (2.8%) and 2 (1.9%) of 106 patients had HBV-DNA and HBVCrAg. The ALT level was higher than 30 IU/L in 146/327 (44.6%) HCVAb-positive patients who had ALT levels measured. Abnormal ALT elevation was more frequent in HCVAb high-titer patients than in low-titer patients (48.3% vs. 26.8%; p = 0.0031), and in HCV-RNA-positive patients than in HCV-RNA-negative patients (54.2% vs. 13.3%; p < 0.001).
Conclusion:
HBV reactivation should be noted in these HCVAb-positive/HBsAg-negative patients on the screening examination if these patients must receive chemotherapy or immunosuppressive therapy. In addition, surveying of HBsAb in addition to HBcAb is also necessary.
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