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Chronic hepatitis C virus infection with exposure to hepatitis B virus
1Liver Unit, Hadassah University Hospital, Jerusalem, Israel.
Insights
Dual hepatitis B and C virus infection is common in Israeli liver disease patients, particularly those of non-Ashkenazi Jewish origin. This dual infection leads to more severe liver complications.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- The prevalence of hepatitis C virus (HCV) infection in Israeli chronic liver disease (CLD) patients was previously unreported.
- HCV and hepatitis B virus (HBV) are significant causes of liver disease globally.
Purpose of the Study:
- To determine the prevalence of dual HBV and HCV infection in patients with anti-HCV positive liver disease in Israel.
- To compare the clinical characteristics and complications between patients with single HCV infection and those with dual HBV/HCV infection.
Main Methods:
- Retrospective analysis of 92 consecutive patients with serologically confirmed anti-HCV and evidence of chronic liver disease.
- Comparison of 31 patients with anti-HCV alone versus 61 patients with evidence of both HBV and HCV infection.
Main Results:
- Dual HBV and HCV infection was found in 66% of anti-HCV positive liver disease patients in Jerusalem.
- Dual infection was significantly more prevalent in Jewish patients of non-Ashkenazi origin.
- Patients with dual infection exhibited higher rates of severe complications, including ascites, esophageal varices, hepatic encephalopathy, and spontaneous bacterial peritonitis.
Conclusions:
- Dual HBV and HCV infection is highly prevalent in this Israeli cohort of patients with anti-HCV positive liver disease.
- Dual infection is associated with increased severity and more serious complications of chronic liver disease.
- Further research into the specific management and outcomes of dual HBV/HCV infections in this population is warranted.
Abstract:
The prevalence of hepatitis C virus (HCV) infection in patients with chronic liver disease (CLD) in Israel has not yet been reported. A retrospective analysis was performed on the first 92 consecutive patients referred to our Liver Unit with serologically confirmed antibodies to hepatitis C virus (anti-HCV) who had evidence for chronic hepatitis, cirrhosis, and hepatocellular carcinoma. We compared 31 patients who were anti-HCV positive with 61 patients who had evidence for both previous or present infection with hepatitis B virus (HBV) as well as HCV. Dual infection was significantly more prevalent in Jewish patients of non-Ashkenazi origin, who were also characterized by higher rates of portal hypertension manifested by ascites, bleeding esophageal varices as well as hepatic encephalopathy and spontaneous bacterial peritonitis. We conclude that dual infection of HBV and HCV was found in 66% of patients with anti-HCV positive liver disease in Jerusalem, and that these patients develop more serious complications than CLD patients with anti-HCV alone.