HBV superinfection in hepatitis C virus chronic carriers, viral interaction, and clinical course.
We enrolled 44 patients with hepatitis B virus (HBV) acute infection, 21 anti-hepatitis C virus (HCV)-positive for at least 1 year (case BC group), 20 anti-HCV-negative (control B group), and 3 with HBV/HCV acute concurrent infection. For each case BC, a subject with chronic HCV infection alone was selected (control C group). At the first observation, 85.7% of patients in case BC group and 85% of those in control B group were HBV-DNA-positive (polymerase chain reaction [PCR]), with a similar trend towards a decrease and negativization in about 20 days; in the case BC group, seroconversion to antibody to hepatitis B e antigen (anti-HBe) was more rapid. HCV-RNA (PCR) was undetectable in all case BC patients but 1, who shortly became negative, whereas 85.7% of subjects in control C group were positive (P <.001). Severe acute hepatitis was more frequent in the case BC group than in the control B group (28.6% vs. 0%, P <.05). Of the 14 patients in the case BC group and of the 16 in the control B group followed up for more than 6 months, 1 in the first and 1 in the second group became hepatitis B surface angiten (HBsAg) chronic carriers. Of the 13 patients in case BC group who recovered, 1 cleared both anti-HCV and HCV-RNA, 6 became HCV-RNA-positive, and 6 remained HCV-RNA-negative. In patients with HBV/HCV acute concurrent infection, HBV-DNA became undetectable in 15 days, and HCV-RNA and anti-HCV became positive at days 30 and 45, respectively; these patients developed HCV-RNA-positive chronic hepatitis. In conclusion, HBV superinfection in chronic HCV carriers has a severe clinical course and strongly and persistently depresses HCV.
Sagnelli
Evangelista
E
Division of Infectious Diseases, Azienda Ospedaliera di Caserta, Naples, Italy. evangelista.sagnelli@unina2.it
Coppola
Nicola
N
Messina
Vincenzo
V
Di Caprio
Domenico
D
Marrocco
Cecilia
C
Marotta
Anna
A
Onofrio
Mirella
M
Scolastico
Carlo
C
Filippini
Pietro
P
D000293:Adolescent; D000328:Adult; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006509:Hepatitis B / Q000453:epidemiology / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D016036:Seroepidemiologic Studies; D015163:Superinfection / Q000453:epidemiology / Q000821:virology*
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral