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Independent and additive effect modification of hepatitis C and B viruses infection on the development of chronic
1Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Insights
Hepatitis B (HBV) and Hepatitis C (HCV) infections are independent risk factors for chronic hepatitis. These viral infections likely interact with an additive effect, increasing disease development.
Area of Science:
- Hepatology
- Virology
- Epidemiology
Background:
- Chronic hepatitis is a significant global health concern.
- Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) may influence disease progression.
- Understanding the interplay between HBV and HCV is crucial for effective management.
Purpose of the Study:
- To evaluate the individual and combined effects of HBV and HCV infections on chronic hepatitis development.
- To investigate the interaction between HBV and HCV in the context of chronic liver disease.
Main Methods:
- Serological detection of anti-HCV and HBsAg in 125 chronic hepatitis patients and 250 healthy controls.
- Statistical analyses including univariate and multivariate analyses, synergy index, and Mantel extension test.
- Assessment of population-attributable risk for each virus and coinfection.
Main Results:
- Prevalence of anti-HCV and HBsAg was significantly higher in chronic hepatitis patients compared to controls (p < 0.0001).
- Both anti-HCV and HBsAg were independently associated with chronic hepatitis, with significant odds ratios.
- Evidence of additive effect modification between HCV and HBV was observed, with higher chronic active hepatitis rates in anti-HCV positive patients.
Conclusions:
- HCV and HBV infections are confirmed risk factors for chronic hepatitis.
- These viral infections exert independent effects and likely interact additively.
- The findings highlight the importance of considering coinfections in chronic hepatitis pathogenesis and management.
Background/Aims:
This study aimed to assess the effects and interaction between hepatitis B virus and hepatitis C virus infection on the development of chronic hepatitis.
Methods:
Anti-HCV and HBsAg were detected in 125 histology-proven chronic hepatitis and 250 sex-matched and age-matched healthy controls.
Results:
The prevalences of anti-HCV (24.8%) and HBsAg (68.0%) in patients were higher than in controls (2.4% and 18.0%, respectively; each p < 0.0001). Univariate analysis showed that anti-HCV and HBsAg were strongly associated with the development of chronic hepatitis. Calculation of synergy index and Mantel extension test for trend indicated that there was additive effect modification between HCV and HBV. Multivariate analysis indicated that anti-HCV (odds ratio, 46.1; 95% confidence interval, 9.1-233.2) and HBsAg (odds ratio, 25.8; 95% confidence interval (9.3-67.2) were independent risk factors of chronic hepatitis. The population-attributable risk was estimated as 15.6% for anti-HCV alone, 52.4% for HBsAg alone and 6.8% for both anti-HCV and HBsAg. The frequency of chronic active hepatitis in patients with anti-HCV alone (100%) was higher than in patients with HBsAg alone (75%, p < 0.001).
Conclusions:
HCV and HBV infections are risk factors of chronic hepatitis. They act independently and probably with additive effect modification.