HBV superinfection in HCV chronic carriers: a disease that is frequently severe but associated with the eradication of HCV.
The impact of hepatitis B virus (HBV) superinfection in hepatitis C virus (HCV) chronic carriers was evaluated in a long-term follow-up study on 29 chronic anti-HCV carriers with acute hepatitis B (AVH-B) (Case group BC) and 29 anti-HCV negative patients with AVH-B (Control group B), pair-matched for age (+/-5 years), sex, and risk factors for the acquisition of HBV infection. Patients in Case group BC and those in Control group B showed similar initial HBV viral load and a similar trend of becoming negative for HBV-DNA. AVH-B showed a severe course more frequently in Case group BC than in Control group B (34.5% versus 6.9%, P < 0.05). Of the 28 patients in Case group BC alive at the end of the acute illness (one death from liver failure), 24 were followed up for 2-6 years, median 5 years: 22 patients became HBsAg-negative and two progressed to HBsAg-positive chronic hepatitis. HCV-RNA was undetectable in all patients during AVH-B; in the 24 patients with a long-term follow-up, HCV-RNA was detected in seven (29.2%) after 1 year, in 14 (58.3%) after 2 years, and in 18 (75%) after 3-6 years. The six patients who eradicated chronic HCV infection, compared with 18 showing reactivation of HCV replication, had higher values of aspartate aminotransferase and alanine aminotransferase and a higher prevalence of cases with severe AVH-B (83.3% versus 22.2%, P < 0.05).


CONCLUSIONS
Although it can be life-threatening, HBV superinfection in HCV chronic carriers may lead to clearance of chronic HCV infection, especially in patients with severe AVH-B.
Sagnelli
Evangelista
E
Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Naples, Italy. evangelista.sagnelli@unina2.it
Coppola
Nicola
N
Pisaturo
Mariantonietta
M
Masiello
Addolorata
A
Tonziello
Gilda
G
Sagnelli
Caterina
C
Messina
Vincenzo
V
Filippini
Pietro
P
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000821:virology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015163:Superinfection / Q000821:virology*; D019562:Viral Load; D055815:Young Adult