title: Previous hepatitis B virus infection is associated with worse disease stage and occult hepatitis B virus infection has low prevalence and pathogenicity in hepatitis C virus-positive patients.
abstract: BACKGROUND
  Anti-hepatitis C virus (anti-HCV) patients with chronic liver disease (CLD) frequently show markers of previous hepatitis B virus (HBV) infection. Moreover, they may carry occult HBV infection. These features might influence clinical and biochemical features as well as stage of disease.
  
  
  OBJECTIVE
  To assess the prevalence and clinical associations of previous (positivity for anti-HBs and/or anti-HBc antibodies) and occult HBV infection (positivity for HBV-DNA by nested-PCR) in the serum of anti-HCV-positive, HCV-RNA-positive, HBsAg-negative patients with various degrees of CLD seen at a tertiary referral centre.
  
  
  METHODS
  A total of 119 patients fulfilled the inclusion criteria (84 chronic hepatitis and 35 liver cirrhosis).
  
  
  RESULTS
  Forty-eight patients (40.3%) showed markers of previous HBV infection. This feature was more frequent (P = 0.02) among cirrhotics (57%) as compared to chronic hepatitis patients (33%). Chronic hepatitis patients positive for markers of previous HBV infection had worse histology as compared to negative ones (grading: 6.4 +/- 2.7 versus 4.6 +/- 3.0, P = 0.004; staging: 1.6 +/- 1.2 versus 1.0 +/- 1.0, P = 0.01). Eight patients were positive for HBV-DNA in serum (6.7%). No difference in the presence of occult HBV infection was seen between various degrees of liver disease (7.1% of chronic hepatitis, 5.7% of cirrhosis) and among patients who were positive (10.4%) or negative (4.2%) for markers of previous HBV infection. No significant biochemical, virological, or histological difference was observed between age, age at infection, duration of infection, marker patterns of previous HBV infection-matched HBV-DNA-positive and negative chronic hepatitis patients.
  
  
  CONCLUSIONS
  Our findings suggest that previous HBV infection among anti-HCV patients is associated with worse disease stage. In these patients, the prevalence of occult HBV infection is low and there is no difference in distribution among patients with or without markers of previous HBV infection. Furthermore, it does not seem to be associated with disease stage. Lastly, at least among patients with chronic hepatitis, it does not seem to affect the severity of disease.
authors.affiliation: Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Giannini
authors.forename: Paola
authors.initials: P
authors.lastname: Ceppa
authors.forename: Federica
authors.initials: F
authors.lastname: Botta
authors.forename: Alberto
authors.initials: A
authors.lastname: Fasoli
authors.forename: Paola
authors.initials: P
authors.lastname: Romagnoli
authors.forename: Filippo
authors.initials: F
authors.lastname: Ansaldi
authors.forename: Paolo
authors.initials: P
authors.lastname: Durando
authors.forename: Domenico
authors.initials: D
authors.lastname: Risso
authors.forename: Pasquale B
authors.initials: PB
authors.lastname: Lantieri
authors.forename: Gian C
authors.initials: GC
authors.lastname: Icardi
authors.forename: Roberto
authors.initials: R
authors.lastname: Testa
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006509:Hepatitis B / Q000097:blood / Q000150:complications* / Q000473:pathology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D016036:Seroepidemiologic Studies
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral