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Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C

Wan-Ting Yang1, Li-Wei Wu, Tai-Chung Tseng

  • 1From the Division of Gastroenterology (T-CT, C-CW), Department of Internal Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation; Division of Gastroenterology (H-CY, T-HS, C-HL, P-JC, C-JL, J-HK), Department of Internal Medicine; Graduate Institute of Clinical Medicine (C-LC, T-HS, C-HL, C-JL, J-HK); Hepatitis Research Center (W-TY, C-HL, J-HK); Department of Medical Research (J-HK); Department of Microbiology (H-CY), National Taiwan University College of Medicine and National Taiwan University Hospital; Master of Public Health Degree Program (W-TY), National Taiwan University, Taipei; Division of Gastroenterology (L-WW), Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei; School of Medicine (T-CT, C-CW), Tzu Chi University, Hualien; Genomics Research Center Academia Sinica (D-SC), Taipei, Taiwan; St Vincent's Hospital (SF-TK), Melbourne VIC, Australia; and Taiwan Liver Disease Consortium (TLC) (C-JL), Taipei, Taiwan.

Medicine
|March 11, 2016
PubMed

Insights

Hepatitis C virus (HCV) coinfection does not impact Hepatitis B virus (HBV) loss. Higher ALT levels predict HBV loss and increase hepatocellular carcinoma (HCC) risk in coinfected patients.

Area of Science:

  • Hepatology
  • Virology
  • Clinical Medicine

Background:

  • Hepatitis B virus (HBV) and hepatitis C virus (HCV) are leading causes of chronic viral hepatitis.
  • The impact of HCV coinfection on HBV replication and patient outcomes remains unclear.

Purpose of the Study:

  • To investigate the effect of HCV coinfection on HBV replication and clinical outcomes.
  • To identify factors influencing HBsAg loss and hepatocellular carcinoma (HCC) development in HBV/HCV coinfected patients.

Main Methods:

  • A 10-year longitudinal study comparing 111 HBV/HCV coinfected patients with 111 propensity score-matched HBV monoinfected controls.
  • Analysis of host and viral factors, including alanine aminotransferase (ALT) levels, correlated with outcomes like HBsAg loss and HCC development.

Main Results:

  • HCV coinfection was not associated with Hepatitis B surface antigen (HBsAg) loss.
  • Patients with ALT levels >80 U/L had a significantly higher chance of HBsAg loss, irrespective of HCV coinfection.
  • Both HCV coinfection and elevated ALT levels were independently associated with increased HCC risk, persisting even after HBsAg loss.

Conclusions:

  • HCV coinfection does not influence HBsAg loss.
  • Elevated ALT levels are a key determinant for HBsAg loss in coinfected individuals.
  • HCV coinfection and higher ALT levels are independent risk factors for HCC development.

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