Prevalence of human cytomegalovirus co-infection in patients with chronic viral hepatitis B and C: a comparison of clinical and histological aspects.
BACKGROUND
Human cytomegalovirus (HCMV) is a common pathogen of severe disease in patients with impaired immune functions. Reactivation of HCMV in immunocompetent host is usually asymptomatic, but may deteriorate the prognosis of patient with chronic illness.


OBJECTIVE
This study was conducted to detect HCMV infection in patients with chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) infections and to point out the effects of HCMV-HBV and HCMV-HCV co-infections on liver histology.


METHODS
Expression of HCMV DNA was determined in liver tissue biopsies by real-time quantitative polymerase chain reaction (qPCR) method. There were 44 chronic HBV, and 25 chronic HCV patients within the study group. Control group consisted of 36 patients with hepatologic malignancies.


RESULTS
HCMV infection was demonstrated in 52.3% of chronic HBV, and 36% of chronic HCV patients. Although alanine aminotransferase (ALT) levels of HCMV-infected HBV patients were decreased slightly, they were increased in HCV patients. Histologic activity scores (necroinflammation and fibrosis) of HCMV-positive patients were higher than that of HCMV-negatives in both HBV and HCV groups. Intrahepatic HBV DNA or HCV RNA loads of the corresponding study groups were decreased in HCMV-infected patients.


CONCLUSIONS
We conclude that HCMV infection is common in chronic HBV and HCV patients, who can be regarded as patients at high risk for HCMV disease. Though the histological changes were more marked in liver, replication of HBV and HCV were inhibited in HCMV-positive cases.
Bayram
Aysen
A
Department of Microbiology and Clinical Microbiology, School of Medicine, University of Gaziantep, Gaziantep, Turkey. aysenbayram@hotmail.com
Ozkur
Ayhan
A
Erkilic
Suna
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D055815:Young Adult
D000410:Alanine Transaminase