Disease and treatment outcome in chronic active hepatitis C with occult HBV infection.
OBJECTIVE
To evaluate the clinical course and effect of antiviral treatment in chronic active hepatitis C with coexisting occult hepatitis B infection.


METHODS
Basic liver enzymes, histological activity of hepatitis (Ishak score), biochemical and virological response rate at the end of treatment and 6 months later of 30 patients (15 of them positive for hepatitis B core antibody in serum) with chronic active hepatitis C are compared. All patients were treated with Interferon alpha-2b 3ME three times weekly and oral Ribavirin 1000/1200 mg daily for six months.


RESULTS
The pure hepatitis C group demonstrates markedly higher biochemical and histological (necroinflammatory) activity. After treatment the pure hepatitis C group shows normalization of serum ALT in 73% (vs. 66% in hepatitis B core antibody-positive patients); loss of detectable HCV-RNA in serum in 47% (vs. 35%) and sustained biochemical response 6 months later in 28% vs. 40% respectively.


CONCLUSIONS
Patients with circulating hepatitis B core antibodies might develop some degree of immune tolerance against hepatitis C virus, with less advanced hepatolysis and necroinflammation even in the presence of HCV viremia and worse virological therapeutic response, associated with frequent sustained ALT normalization.
Berberova
Magda
M
Clinic of Gastroenterology, Medical University Hospital Queen Joanna, 8 Bialo more str., Sofia 1527, Bulgaria. mberberova@yahoo.co.uk
Mendizova
Antonia
A
Popchristova
Elisaveta
E
Krastev
Nikolay
N
Genov
Jordan
J
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001707:Biopsy, Needle; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*
D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D018937:Hepatitis C Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin