Prevalence and significance of hepatitis C viremia in chronic active hepatitis B.
OBJECTIVE
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.
Crespo
J
J
Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Lozano
J L
JL
de la Cruz
F
F
Rodrigo
L
L
Rodríguez
M
M
San Miguel
G
G
Artiñano
E
E
Pons-Romero
F
F
D000328:Adult; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology*; D006515:Hepatitis B virus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology*; D006521:Hepatitis, Chronic / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D015151:Immunoblotting; D008297:Male; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D014766:Viremia / Q000453:epidemiology / Q000382:microbiology*
D004279:DNA, Viral; D012367:RNA, Viral