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Prevalence and significance of hepatitis C viremia in chronic active hepatitis B
J Crespo1, J L Lozano, F de la Cruz
1Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Insights
Hepatitis C virus (HCV) infection is common in chronic active hepatitis B patients and may worsen liver disease severity. Co-infection is more frequent when hepatitis B virus (HBV) DNA is not detected by dot-blot hybridization.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Chronic active hepatitis B (CAHB) is a significant liver disease.
- Hepatitis C virus (HCV) co-infection is a potential complicating factor in CAHB management.
- Understanding the interplay between HBV and HCV is crucial for patient outcomes.
Purpose of the Study:
- To determine the prevalence of HCV infection in patients with CAHB.
- To evaluate the clinical and histological significance of HCV co-infection in this population.
- To investigate the impact of co-infection on liver disease severity and viral replication.
Main Methods:
- Study included 132 patients with CAHB, with 17 co-infected with HCV.
- HBV-DNA detection using dot-blot hybridization and PCR.
- HCV-RNA detection using ELISA-2, RIBA-2, and RT-PCR.
Main Results:
- HBV-DNA by dot-blot was detected in 29.4% of HCV-RNA-positive patients vs. 55.6% of HCV-RNA-negative patients (p < 0.05).
- Similar low levels of HBV replication (PCR) were observed in both groups.
- HCV-RNA-positive patients exhibited significantly higher AST, ALT, gamma-globulin levels, and liver damage scores.
Conclusions:
- HCV co-infection is frequent in CAHB patients.
- HBV/HCV co-infection is more common when HBV-DNA is undetectable by dot-blot.
- Liver disease appears more severe in co-infected patients, suggesting a significant role for HCV in persistent liver disease.
Objectives:
To assess the prevalence and significance of HCV infection in patients with chronic active hepatitis B.
Methods:
We studied clinical and histological activity in 132 patients with chronic active hepatitis B, 17 of whom were co-infected by HCV. Serum HBV-DNA was determined by dot-blot hybridization and polymerase chain reaction (PCR) and serum HCV-RNA was determined by ELISA-2, RIBA-2, and reverse transcription PCR (RT-PCR).
Results:
HBV-DNA was detected by dot-blot in five of 17 (29.4%) patients in the HCV-RNA-positive group and in 64 of 115 (55.6%) in the HCV-RNA-negative group (p < 0.05). The low levels of HBV replication (assessed by PCR) were similar in both groups. Mean levels of serum AST, ALT, and gamma-globulin, as well as mean scores of liver damage, were significantly higher among HCV-RNA-positive patients than among HCV-RNA-negative patients.
Conclusions:
1) Concomitant HCV infection occurs frequently in patients with chronic active hepatitis B; 2) co-infection of HBV and HCV is more common in the absence of HBV-DNA detected by dot-blot hybridization; 3) liver disease seems to be more severe in patients with concomitant HBV and HCV infection, even though the number of replicative HBV patients was lower in the group of HCV-infected patients. This suggests that the role of HCV is probably important as the cause of persistent liver disease. 4) The detection of HBV-DNA by dot-blot and HCV-RNA by PCR could help to establish whether HBV, HCV, or both contribute to liver injury.