Acute hepatitis B in patients with or without underlying chronic HCV infection.
OBJECTIVE
Acute hepatitis B course may be significantly modified by underlying chronic hepatitis C. The aim of this study was to compare clinical and virological characteristics of acute hepatitis B in patients with or without chronic hepatitis C virus (HCV) infection.


METHODS
Twenty-seven patients with symptomatic acute hepatitis B were enrolled: 14 with underlying chronic HCV (Group A) and 13, matched by age and gender, with single hepatitis B (Group B). All patients were followed-up until HBsAg negativization.


RESULTS
Group A patients were HCV-RNA-negative on hospital admission and all but one remained negative during follow-up. HBeAg tested positive in 92.9% and 84.6% of Groups A and B patients, respectively. ALT, bilirubin, prothrombin time values and HBsAg titer were similar in both groups. Nevertheless, lower mean HBV-DNA levels (p=0.03), a shorter duration of HBsAg positivity (p<0.01) and of symptoms before ALT peak (p=0.014), and significantly lower peak ALT values (p=0.03) were observed in Group A compared to Group B patients.


CONCLUSIONS
Acute HBV infection suppressed HCV replication. Conversely, the underlying HCV infection exerted a modulatory effect on HBV replication which influenced the course, though not the outcome, of the acute disease. Although acute hepatitis B showed a mild clinical course in both groups of patients, HBV vaccination should be suggested to risk subjects.
Department of Infectious and Tropical Diseases, University La Sapienza of Rome, Italy.
E
E
Biliotti
L A
LA
Kondili
C
C
Furlan
G
G
Ferretti
S
S
Zacharia
M
M
De Angelis
S
S
Guidi
N
N
Gusman
G
G
Taliani
D000208:Acute Disease; D004279:DNA, Viral / Q000276:immunology; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D018937:Hepatitis C Antibodies / Q000097:blood / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000032:analysis* / Q000276:immunology; D016036:Seroepidemiologic Studies; D015163:Superinfection / Q000453:epidemiology / Q000821:virology*; D014779:Virus Replication
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral