title: Hepatitis B infection of the liver in chronic hepatitis C without detectable hepatitis B virus DNA in serum.
abstract: 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.
authors.affiliation: Fundación para el Estudio de las Hepatitis Virales, Madrid, Spain.
authors.forename: Luisa Fernanda
authors.initials: LF
authors.lastname: Mariscal
authors.forename: Elena
authors.initials: E
authors.lastname: Rodríguez-Iñigo
authors.forename: Javier
authors.initials: J
authors.lastname: Bartolomé
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Castillo
authors.forename: Nuria
authors.initials: N
authors.lastname: Ortiz-Movilla
authors.forename: Cristina
authors.initials: C
authors.lastname: Navacerrada
authors.forename: Margarita
authors.initials: M
authors.lastname: Pardo
authors.forename: Arturo
authors.initials: A
authors.lastname: Pérez-Mota
authors.forename: Javier
authors.initials: J
authors.lastname: Graus
authors.forename: Vicente
authors.initials: V
authors.lastname: Carreño
mesh_terms: 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
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens