Influence of chronic coinfection with hepatitis B and C virus on liver histology.
BACKGROUND
Few data are available on histological features of chronic hepatitis B (HBV) and C (HCV) virus coinfection.


METHODS
We enrolled 142 consecutive patients with viral chronic hepatitis on their first liver biopsy: 27 HBsAg and anti-HCV positive (case BC group), 57 HBsAg positive and anti-HCV negative (control B group) and 58 anti-HCV positive, HBsAg/anti-HBs/anti-HBc negative (control C group).


RESULTS
Patients in the case BC group showed serum HBVDNA (37% vs 71.9%, p < 0.005) and ground-glass hepatocytes (37% vs 66.7%, p < 0.01) less frequently than those in the control B group. The case BC group showed a lower prevalence of patients with detectable HCV-RNA than the control C group (60% vs 92.3%, p < 0.001) and a significantly higher fibrosis score (2.1 +/- 1.2 vs 1.5 +/- 1.1, p < 0.05). Of the 27 patients in the case BC group, 10 lacked serum HCV-RNA and showed significantly higher histological activity index (HAI) and fibrosis scores than those found in the 17 HCV-RNA positive (8.5 +/- 4.4 vs 5.4 +/- 2.4 for HAI, p < 0.05; 3.0 +/- 1.3 vs 1.69 +/- 1.0, p < 0.05 for fibrosis).


CONCLUSIONS
Liver histology seems to be more severe in chronic coinfection with HBV and HCV than in single infection, particularly when HCV replication is impaired.
Sagnelli
E
E
Division of Infectious Diseases, San Sebastian Hospital and the Dept. of Public Medicine, Second University of Naples, Hospital Gesù and Maria, Italy. evangelista.sagnelli@unina2.it
Pasquale
G
G
Coppola
N
N
Scarano
F
F
Marrocco
C
C
Scolastico
C
C
Santantonio
T
T
Gentile
A
A
Piccinino
F
F
D000328:Adult; D004279:DNA, Viral / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012720:Severity of Illness Index
D004279:DNA, Viral; D012367:RNA, Viral