Hepatitis B infection of the liver in chronic hepatitis C without detectable hepatitis B virus DNA in serum.
Hepatitis B virus (HBV) DNA may persist in the liver in the absence of serum HBV-DNA after a self-limited acute hepatitis B. This may also occur in patients with chronic hepatitis C virus (HCV) infection but its prevalence and its impact on liver histology is unknown. HBV-DNA was tested by polymerase chain reaction (PCR) and by in situ hybridisation in liver biopsies from 98 patients with chronic hepatitis C who were hepatitis B surface antigen negative and serum HBV-DNA negative by PCR. HBV-DNA resulted positive in the liver of 37/98 (37.7%) patients without serum HBV-DNA. To test whether these patients had serum HBV-DNA levels under the detection limit of the PCR assay used in this study (50 copies/ml), PCR products in which HBV-DNA was undetectable after visualization of agarose gels were analysed by dot-blot hybridisation. With this method, HBV-DNA was positive in serum of 12/37 patients with liver HBV-DNA. Thus, 25/98 (25.5%) patients have HBV-DNA detectable only in liver. This was confirmed by in situ hybridisation, the percentage of infected hepatocytes ranging from 0.1% to 12%. In patients in whom the HCV infection was shorter than 20 years, HBV infected patients had higher (P = 0.01) fibrosis score (1.64 +/- 1.21) than HBV negative cases (0.53 +/- 0.66). In conclusion, a significant proportion of patients with chronic HCV infection have HBV-DNA in the liver in the absence of viral DNA in serum. The impact of this finding on liver histology deserves further research.
Mariscal
Luisa Fernanda
LF
Fundación para el Estudio de las Hepatitis Virales, Madrid, Spain.
Rodríguez-Iñigo
Elena
E
Bartolomé
Javier
J
Castillo
Inmaculada
I
Ortiz-Movilla
Nuria
N
Navacerrada
Cristina
C
Pardo
Margarita
M
Pérez-Mota
Arturo
A
Graus
Javier
J
Carreño
Vicente
V
D000328:Adult; D001483:Base Sequence; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis* / Q000097:blood* / Q000737:chemistry; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000821:virology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000150:complications*; D022781:Hepatocytes / Q000821:virology; D006801:Humans; D017403:In Situ Hybridization; D008099:Liver / Q000473:pathology / Q000821:virology*; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D016415:Sequence Alignment; D017422:Sequence Analysis, DNA
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens