Effect of concurrent acute infection with hepatitis C virus on acute hepatitis B virus infection.
OBJECTIVE
To investigate the possible interference with acute hepatitis B virus infection by co-infection with hepatitis C virus.


METHODS
Analysis of stored sera collected for transfusion transmitted viruses study in 1970s.


METHODS
Four major medical centres in the United States.


METHODS
12 recipients of blood infected with hepatitis B virus.


METHODS
In 1970s, presence of antibodies in hepatitis B virus and raised serum alanine aminotransferase concentration; detection of antibodies to hepatitis C virus with new enzyme linked immunoassays.


RESULTS
Five of the 12 patients were coinfected with hepatitis C virus. Hepatitis B surface antigen was first detected at day 59 in patients infected with hepatitis B virus alone and at day 97 in those coinfected with hepatitis C virus (p = 0.01); median durations of antigenaemia were 83 and 21 days respectively (p = 0.05), and the antigen concentration was lower in the coinfected patients. Alanine aminotransferase patterns were uniphasic when hepatitis B virus infection occurred alone (range 479-2465 IU/l) and biphasic in patients with combined acute infection (no value > 380 IU/l; p = 0.0025). Four coinfected recipients developed chronic hepatitis C virus infection. The fifth patient was followed for only four months.


CONCLUSIONS
Acute coinfection with hepatitis C virus and hepatitis B virus inhibits hepatitis B virus infection in humans, and onset of hepatitis B may reduce the severity of hepatitis C virus infection but not frequency of chronicity. Alanine aminotransferase concentration showed a biphasic pattern in dual infection.
Mimms
L T
LT
Abbott Laboratories, Abbott Park, Illinois.
Mosley
J W
JW
Hollinger
F B
FB
Aach
R D
RD
Stevens
C E
CE
Cunningham
M
M
Vallari
D V
DV
Barbosa
L H
LH
Nemo
G J
GJ
D000208:Acute Disease; D000410:Alanine Transaminase / Q000378:metabolism; D006509:Hepatitis B / Q000150:complications* / Q000201:enzymology / Q000276:immunology; D006512:Hepatitis B Core Antigens / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000150:complications* / Q000201:enzymology / Q000276:immunology; D006801:Humans
D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D000410:Alanine Transaminase