Double infections with hepatitis A and B viruses

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis B virus (HBV) infection is a significant global health concern.
• Hepatitis A virus (HAV) is a common cause of acute viral hepatitis.
• Coinfection with different hepatitis viruses can complicate diagnosis and management.

Purpose of the Study:

• To investigate the clinical and serological characteristics of patients with acute hepatitis A (HAV) who were also carriers of hepatitis B surface antigen (HBsAg).
• To assess the impact of HAV superinfection on HBV replication and disease course in HBsAg carriers.
• To highlight the importance of diagnosing dual HAV and HBV infections in endemic areas.

Main Methods:

• Prospective study of 356 adult patients admitted with acute viral hepatitis A.
• Screening for HBsAg and HBV DNA in patients with acute HAV.
• Clinical, biochemical, and serological evaluation of patients.
• Monitoring of HBV replication markers (HBV DNA, HBeAg, anti-HBe) in carriers.

Main Results:

• Ten HBsAg carriers (2.8%) and four patients with acute HBV infection (1.1%) were identified among 356 adults with acute HAV.
• These coinfected patients showed similar clinical and biochemical profiles to those with HAV alone.
• Transient suppression of HBV replication and seroconversion from HBeAg positive to anti-HBe positive were observed in some carriers.

Conclusions:

• Superinfection with HAV does not appear to cause more severe liver disease or adversely affect the course of chronic hepatitis B.
• Accurate diagnosis of dual HAV and HBV infections is essential for patient prognosis and public health management.
• Dual infections are relatively common in areas with high HBV prevalence, necessitating vigilance in diagnosis and patient care.