Senturk H; Tahan V; Canbakan B; Dane F; Ulger Y; Ozaras R; Tabak F; Mert A; Ozbay G

Language: Spanish
References: 24
Page: 52-58
PDF size: 333.14 Kb.

Text Extraction

There is controversial data in the literature about the characteristics or features of dual hepatitis B and C infection. Several studies have reported that the dual infection has a more severe histological picture; faster progression leading to cirrhosis and a higher risk for hepatocellular carcinoma compared with the single infections. These findings have not yet been supported. We assessed the patients with dual hepatitis B and C infection with respect to their different features in our country. Method: the chronic hepatitis patients of our clinics were tested, and both HBsAg and anti-HCV positive patients with chronic hepatitis were enrolled to the study. All patients were tested for the biochemical parameters and the presence of HBV-DNA and HCV-RNA. Results: Of the 1950 patients, 51 (2.6%) were both HBsAg and anti-HCV positive and 67 were anti-delta positive. Patients were followed up for 5.4 ± 2.1 years. Of the 51 dual hepatitis patients, 6 had no HBV-DNA and HCV-RNA detectable by PCR, 36 were only HCV-RNA positive, 9 were only HBV-DNA positive and 3 were both HBV-DNA and HCV-RNA positive. Dominant infection in ¾ of the patients was hepatitis C. Clinical and histological properties of the cases with dual Hepatitis B and C infection showed no significant differences compared to the single infections. In conclusion, regarding the prognosis, no significant differences were found between such dual and single infections. Dual infection with hepatitis B virus and delta virus is a significantly more severe condition than the dual infection with hepatitis B and C viruses.

REFERENCES

1. Stroffolini T, Sagnelli E, Mele A, Craxi A, Almasio P and Italian Hospitals Collaborating Group. The etiology of Chronic Hepatitis in Italy: Results from a multicentre national study. Dig Liver Dis 2004; 36: 829-33.

2. Zarski J-P, Bohn B, Bastie A, et al. Characteristics of patients with dual infection by hepatitis B and C viruses. J Hepatol 1998; 28: 27-33.

3. Mathurin P, Thibault V, Kadidja, et al. Replication status and histological features of patients with triple (B, C, D) and dual (B, C) hepatic infections. J Viral Hep 2000; 7: 15-22.

4. Jardi R, Rodriguez F, Buti M, et al. Role of hepatitis B, C, and D viruses in dual and triple infection: Influence of viral genotypes and hepatitis B precore and basal core promoter mutations on viral replicative interference. Hepatology 2001; 34: 404-10.

5. Sagnelli E, Pasquale G, Coppola N, et al. Influence of chronic infection with hepatitis B and C virus on liver histology. Infection 2004; 32: 144-8.

6. Gaeta GB, Stornaiuolo G, Precone DF, et al. Epidemiological and clinical burden of chronic hepatitis B virus/hepatitis C virus infection. A multicenter Italian study. J Hepatol 2003; 39: 1036-41.

7. Villa E, Grottola A, Buttafaco P, et al. High doses of alfa-interferon are required in chronic hepatitis due to coinfection with hepatitis B virus and hepatitis C virus: Long term results of a prospective randomized trial. Am J Gastroenterol 2001; 96: 2973-7.

8. Fukuda R, Ishimura N, Nigaki M, et al. Serologically silent hepatitis B virus coinfection in patients with hepatitis C virus associated chronic liver disease: Clinical and virological significance. J Med Virol 1999; 58: 201-7.

9. Lee D-S, Huh K, Lee E-H, Lee D-H, Hong K-S, Sung Y-C. HCV and HBV coexist in HBsAg-negative patients with HCV viraemia: Possibility of coinfection in these patients must be considered in HBV-high endemic area. J Gastroenterol Hepatol 1997; 12: 855-61.

10. Sagnelli E, Coppola N, Scolastico C, Mogavero AR, Filippini P, Piccinino F. HCV genotype and silent HBV coinfection: Two main risk factors for a more severe liver disease. J Med Virol 2001; 64: 350-5.

11. Farci P. Delta hepatitis: an update. J Hepatol 2003; 39: 212-9.

12. Hadziyannis SJ. Hepatitis delta: an overview. In Rizzetto M, Purcell RH, Gerin JL, editors. Viral hepatitis and Liver disease. Turin, Italy: Minerva Medica; 1997: 283-9.

13. Kubo S, Nishiguchi S, Hirohashi K, et al. Clinical significance of prior hepatitis B virus infection in patients with hepatitis C virus-related hepatocellular carcinoma. Cancer 1999; 86: 793-8.

14. Ruiz J, Sangro B, Cuende JI, et al. Hepatitis B and C viral infections in patients with hepatocellular carcinoma. Hepatology 1992; 16: 637-41.

15. Shiratori Y, Shiina S, Zhang PY, et al. Does dual infection by hepatitis B and C viruses play an important role in the pathogenesis of hepatocellular carcinoma in Japan? Cancer 1997; 80: 2060-7.

16. Chomcynski P, Sacci N. Single step method of RNA isolation by acid-guanidium thiocyanate-phenol-chloroform axtraction. Anal Biochem 1984; 162: 156-9.

17. Cacciola I, Pollicino T, Squadrito G, Cerenzia G, Orlanda ME, Raimondo G. Occult hepatitis B virus infection in patients with chronic hepatitis C liver disease. N Engl J Med 1999; 341: 22-6.

18. Pontisso P, Ruvoletto MG, Fattovich G, et al. Clinical and virological profiles in patients with multiple hepatitis B virus infection. Gastroenterology 1993; 105: 1529-33.

19. Villari D, Pernice M, Spinella S, et al. Chronic hepatitis in patients with active hepatitis B virus and hepatitis C virus combined infections: A histological study. Am J Gastroenterol 1995; 90: 955-8.

20. Dries V, Von Both I, Muller M, et al. Detection of hepatitis C in parafin-embedded liver biopsies of patients negative for viral RNA in serum. Hepatology 1999; 29: 223-9.

21. Squadrioto G, Orlando ME, Pollicino T, et al. Virological profiles in patients with chronic hepatitis C and overt or occult HBV infection. Am J Gastorenterol 2002; 97: 1518-23.

22. Wu JC, Chen CL, Hou MC, Chen TZ, Lee SD, Lo KJ. Multiple viral infection as the most common cause of fulminant and subfulminant viral hepatitis in an endemic area for hepatitis B: Application and limitation of the polymerase chain reaction. Hepatology 1994; 19: 836-40.

23. Chu CM, Sheen IS, Liaw YF. The role of hepatitis C virus in fulminant viral hepatitis in an endemic area of hepatitis A and B. Gastroenterology 1994; 107: 189-95.

24. Liaw Y-F. Role of hepatitis C virus in dual and triple hepatitis virus infection. Hepatology 1995; 22: 1101-8.