Characteristics of patients with dual infection by hepatitis B and C viruses

• Published in: Journal of hepatology 1998, Vol.28 (1), p.27-33
• Main Authors: Zarski, Jean-Pierre, Bohn, Benoit, Bastie, Anne, Pawlotsky, Jean-Michel, Baud, Maryline, Bost-Bezeaux, Frédérique, van Nhieu, Jeanne Tran, Seigneurin, Jean-Marie, Buffet, Catherine, Dhumeaux, Daniel
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Biopsy, Needle; Blood Transfusion; Chronic hepatitis; DNA, Viral - analysis; Enzyme-Linked Immunosorbent Assay; Female; HBV-HCV; Hepacivirus - isolation & purification; Hepatitis B - complications; Hepatitis B - epidemiology; Hepatitis B - pathology; Hepatitis B - physiopathology; Hepatitis B e Antigens - blood; Hepatitis B Surface Antigens - blood; Hepatitis B virus - isolation & purification; Hepatitis C - complications; Hepatitis C - epidemiology; Hepatitis C - pathology; Hepatitis C - physiopathology; Human viral diseases; Humans; Infectious diseases; Liver - pathology; Liver Function Tests; Male; Medical sciences; Polymerase Chain Reaction; RNA, Viral - analysis; Substance-Related Disorders; Viral diseases; Viral hepatitis; Viral interference
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/S0168-8278(98)80198-0

Background/Aims: The purpose of this study was to compare the epidemiological, biochemical, virological and histological characteristics of patients with chronic hepatitis B and C with those of patients suffering from chronic hepatitis C alone. Methods: Twenty-three patients with chronic hepatitis C, who were anti-HCV positive and HBs antigen positive, were studied and subdivided into two groups according to the presence or absence of HBV DNA replication. They were compared to 69 age- and sex-matched patients with chronic hepatitis who were anti-HCV positive and HBs antigen negative. All patients were HCV RNA positive by PCR, anti-HIV negative and anti-HDV negative. HBV DNA and HCV RNA were detected in serum by means of a branched DNA assay and PCR. The HCV serotypes were determined by the Chiron Riba HCV serotyping SIA technique. The histological characteristics included the Knodell score. Results: Epidemiological, biochemical and virological parameters were not different between the two groups. Only the prevalence of cirrhosis was greater in chornic hepatitis B and C patients than in patients with chronic hepatitis C alone ( p=0.01). Among chronic hepatitis B and C patients, HCV RNA level was significantly lower in HBV DNA positive than in HBV DNA negative patients ( p=0.01). Indeed, histological lesions were more severe in HBV DNA positive than in HBV DNA negative patients, including prevalence of cirrhosis ( p=0.01), Knodell score ( p=0.05) and, among the latter, piecemeal necrosis ( p=0.01) and fibrosis ( p=0.05). The characteristics of patients with dual infection did not differ according to the mode of contamination and duration of HBV disease, except for a shorter duration in patients contaminated by drug abuse than in other patients. Conclusions: These results suggest that HBV DNA replication inhibits HCV RNA replication in patients with chronic active hepatitis B and C but increases the severity of histological lesions.