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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
PCR-Based Molecular Diagnosis of Hepatitis Virus (HBV and HDV) in HCV Infected Patients and Their Biochemical Study
Muhammad Nasir Riaz1, Muhammad Faheem2, Muhammad Ayaz Anwar3
1Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad 44000, Pakistan; Department of Microbiology, Hazara University, Mansehra 21120, Pakistan.
Insights
Hepatitis C virus (HCV) coinfections with Hepatitis B virus (HBV) and Hepatitis D virus (HDV) are common in Pakistani patients with liver disease. Triple infections showed the most severe liver function test alterations and were linked to intravenous drug use.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection affects over 10% of patients with Hepatitis B virus (HBV) or Hepatitis D virus (HDV) globally, contributing to liver disease.
- Coinfection with HBV and HDV alongside HCV presents a complex clinical challenge, particularly in regions with high endemicity.
Purpose of the Study:
- To investigate the association of HBV and HDV coinfections with HCV in Pakistani patients.
- To evaluate the impact of these coinfections on liver disease severity.
- To identify potential risk factors associated with coinfected patients.
Main Methods:
- A cohort of 730 liver disease patients was analyzed.
- HCV infection was confirmed using PCR in 501 patients.
- Seroprevalence of HBV and HDV coinfections was determined, and liver function tests (LFTs) were assessed.
Main Results:
- 5.1% of patients were coinfected with HBV, and 1% were coinfected with both HBV and HDV.
- Liver function tests, including bilirubin, AST, and ALT, were significantly altered in dually and triply infected patients compared to those with single HCV infection.
- The highest LFTs were observed in triple infections (bilirubin: 3.25 mg/dL, AST: 174 IU/L, ALT: 348 IU/L).
- Reuse of syringes was a prominent risk factor for single (22%) and dual (27%) infections, while intravenous drug use was highest in triple infections (60%).
Conclusions:
- HBV and HDV coinfections are significantly associated with HCV-infected patients in Pakistan.
- The possibility of dual and triple viral hepatitis coinfections should be considered in cases of severe liver disease.
- Understanding risk factors like syringe reuse and intravenous drug use is crucial for managing coinfections.
Abstract:
Seroprevalence of HCV indicates that HCV is found in more than 10% of HBV- or HDV-infected patients worldwide leading to liver disease. Here we show HBV and HDV coinfection association with HCV infected Pakistani patients, study of disease severity, and possible interpretation of associated risk factors in coinfected patients. A total of 730 liver diseased patients were included, out of which 501 were found positive for HCV infection via PCR. 5.1% of patients were coinfected with HBV while 1% were coinfected with HBV and HDV both. LFTs were significantly altered in dually and triply infected patients as compared to single HCV infection. Mean bilirubin, AST, and ALT levels were highest (3.25 mg/dL, 174 IU/L, and 348 IU/L) in patients with triple infection while dual infection LFTs (1.6 mg/dL, 61 IU/L, and 74 IU/L) were not high as in single infection (1.9 mg/dL, 76 IU/L, and 91 IU/L). The most prominent risk factor in case of single (22%) and dual infection (27%) group was "reuse of syringes" while in triple infection it was "intravenous drug users" (60%). It is concluded that HBV and HDV coinfections are strongly associated with HCV infected Pakistani patients and in case of severe liver disease the possibility of double and triple coinfection should be kept in consideration.
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