title: Clinical and virological profiles in patients with multiple hepatitis virus infections.
abstract: BACKGROUND
  The "in vivo" interplay between hepatitis B virus (HBV) and hepatitis C virus (HCV) both in terms of replication activity and cytopathic effect on liver cells is poorly understood. The aim of the study was to investigate their reciprocal influence in patients with HBV and HCV coinfection.
  
  
  METHODS
  HBV and HCV genomic sequences in the serum and liver of 55 patients with chronic liver disease who were positive for anti-HCV and for markers of HBV were studied.
  
  
  RESULTS
  Twenty-five hepatitis B surface antigen-positive patients, without markers of hepatitis D virus (HDV) infection, showed an inverse relation between seropositivity for HCV RNA and for HBV DNA (P < 0.001). HCV genomic sequences were detected in the liver of all patients positive for HBV DNA but negative for HCV RNA in serum. The biochemical activity and the histological severity of liver disease were lower in HCV RNA-positive/HBV DNA-negative patients, compared with HCV RNA (serum)-negative/HBV DNA-positive cases (P < 0.005). Nine of 10 patients with concurrent HDV infection were negative for serum and liver HCV RNA. None of 20 hepatitis B surface antigen-negative/HCV RNA-positive patients with antibodies to HBV had HBV DNA detectable in serum or liver.
  
  
  CONCLUSIONS
  Our findings indicate a reciprocal inverse relation between HBV and HCV replication. Patients positive for antibody to HCV with antibodies to HBV usually have no evidence of HBV DNA persistence in the liver.
authors.affiliation: Istituto di Medicina Clinica, Università di Padova, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Pontisso
authors.forename: M G
authors.initials: MG
authors.lastname: Ruvoletto
authors.forename: G
authors.initials: G
authors.lastname: Fattovich
authors.forename: L
authors.initials: L
authors.lastname: Chemello
authors.forename: A
authors.initials: A
authors.lastname: Gallorini
authors.forename: A
authors.initials: A
authors.lastname: Ruol
authors.forename: A
authors.initials: A
authors.lastname: Alberti
mesh_terms: D001483:Base Sequence; D002353:Carrier State; D004279:DNA, Viral / Q000097:blood; D016174:Hepacivirus / Q000235:genetics / Q000502:physiology*; D006509:Hepatitis B / Q000150:complications / Q000382:microbiology*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics / Q000502:physiology*; D006526:Hepatitis C / Q000150:complications / Q000382:microbiology*; D006801:Humans; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000097:blood; D014779:Virus Replication
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral