[HCV superinfection in a chronic carrier of HBV].
The paper reports a case of acute hepatitis C (HCV) in a patient who was a chronic carrier of hepatitis B virus (HBV) during the course of which the authors observed a transient HBsAg clearance. The 53-year-old patient was a carrier of chronic HBV infection in an integrated minus variant phase. The patient presented an abrupt increment in aminotransferase (ALT) which was not compatible with the typical "a poussée" progress of atypical chronic HBV hepatitis in that it was associated with HbsAg clearance in the absence of signs of superinfection by delta hepatitis virus (HDV), with subsequent repositivisation of HBsAg and contemporary anti-HCV seroconversion (RIBA positive for C-22, C-33, C-100, 5-1-1) on clinical remission. Polymerase chain reaction (PCR) was negative on remission for both HBV DNA and HCV. RNA became positive six months afterwards for HCV RNA alone; moreover HBsAg, anti-HCV, RIBA C-22, C-33, C-100, 5-1-1 were constantly positive, thus further confirming the inhibitory capacity of HCV towards HBV and not vice versa, as also shown by the chronic nature of infection and deterioration of clinical conditions. The authors conclude by underlining the need to assay for HCV RNA using a PCR method in alla cases of re-acutisation of chronic hepatitis due to both wild virus B and the domestic virus during the course of which HBsAg becomes negative, even transiently, in the absence of Delta superinfection.
Romano
M
M
II Divisione di Medicina, Ospedale Sandro Pertini, Roma.
Di Napoli
M
M
Pesce
M
M
D002908:Chronic Disease; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006509:Hepatitis B / Q000175:diagnosis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000175:diagnosis; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D015151:Immunoblotting; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D015163:Superinfection
D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral
Superinfezione da HCV in portatore cronico di HBV.