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Hepatitis B and D genomes in hepatitis B surface antigen negative patients with chronic hepatitis C
S González1, S Navas, A Madejón
1Hepatology Unit, Fundación Jiménez Díaz, Madrid, Spain.
Insights
Hepatitis B and D viral genomes are common in patients negative for Hepatitis B surface antigen but positive for Hepatitis C antibodies. This high prevalence was observed regardless of Hepatitis C virus RNA presence.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection is often diagnosed by anti-HCV antibodies.
- Hepatitis B virus (HBV) and Hepatitis D virus (HDV) coinfections can complicate liver disease.
- Detecting HBV and HDV in HBsAg-negative individuals requires sensitive methods.
Purpose of the Study:
- To investigate the prevalence of HBV and HDV genomes in HBsAg-negative patients with anti-HCV.
- To determine if HCV RNA status influences HBV/HDV detection.
- To explore potential risk factors for coinfection.
Main Methods:
- Nested polymerase chain reaction (PCR) was used to detect HBV and HDV genomes.
- Samples included serum and liver biopsies from 69 HBsAg-negative, anti-HCV positive patients.
- Patients were stratified based on the presence (n=47) or absence (n=22) of HCV RNA.
Main Results:
- HBV DNA was detected in 49% of patients with HCV RNA and 64% without HCV RNA.
- Intrahepatic HBV DNA was found in 80% of analyzed liver biopsies.
- HDV genome was detected in 72-73% of anti-HCV positive patients, irrespective of HCV RNA.
- Simultaneous HBV and HDV genomes were more frequent in transfused patients with HCV RNA.
Conclusions:
- A significant proportion of HBsAg-negative, anti-HCV positive patients harbor HBV and HDV genomes.
- The presence of HBV and HDV is largely independent of HCV RNA status.
- Further research is needed to understand the clinical significance of these findings.
Abstract:
Hepatitis B and hepatitis D viral genomes were tested by nested polymerase chain reaction in the serum and liver of 69 hepatitis B surface antigen (HBsAg) negative, anti-hepatitis C virus (HCV) positive patients (47 with HCV RNA and 22 without HCV RNA). Serum hepatitis B virus (HBV) DNA-was detected in 49% of the patients with HCV-RNA and in 64% of those without HCV-RNA. Furthermore, intrahepatic HBV-DNA was found in four of five (80%) of the biopsies analysed. Delta genome was found in 72% and 73%, respectively, of the anti-HCV positive patients with or without HCV-RNA. In addition, intrahepatic delta virus genome was detected in another four liver biopsies studied. In the group of patients with HCV-RNA, the simultaneous presence of hepatitis B and D genomes was statistically higher in transfused patients than in drug addicts, or in those with an unknown infection route (P < 0.001). These results show a high percentage of B and D genomes in HBsAg negative patients with anti-HCV, irrespective of the presence or absence of the HCV genome. However, the clinical implications of this finding should be examined in future studies.