Hepatitis B virus and hepatitis C virus dual infection among patients with chronic liver disease.
OBJECTIVE
Hepatitis B virus (HBV) and hepatitis C virus (HCV) dual infection accounts for a substantial proportion of liver diseases worldwide. Although the exact prevalence is not known, these viral infections are common among patients with chronic liver disease (CLD). This study was performed to determine the prevalence of HBV and HCV dual infection among patients with CLD in Chennai, India.


METHODS
251 patients were tested for the presence of hepatitis B surface antigen (HBsAg), immunoglobulin (Ig)-M/IgG antibody to hepatitis B core antigen (anti-HBc) and anti-HCV antibodies, and HBV-DNA and HCV-RNA by qualitative polymerase chain reaction.


RESULTS
Coinfection with HCV and HBV was detected in 15 patients (5.9%), 12 of whom (80.0%) were positive for HCV-RNA and IgG anti-HBc with no evidence of HBV-DNA, while 3 HBsAg-negative patients (20.0%) were positive for HBV-DNA in addition to HCV-RNA. Liver function test profiles were significantly altered for HCV-positive patients compared with HBV-positive and HBV/HCV coinfected patients (p = 0.001). Bilirubin and alanine aminotransferase levels were significantly raised in coinfected patients compared with non-HBV, non-HCV patients (p = 0.001).


CONCLUSIONS
The results demonstrated that HBV was predominantly associated with underlying CLD among this group of patients in India and suggest that HBV coinfection in HCV-infected patients should not be excluded by negative HBsAg status alone.
Saravanan
Shanmugam
S
Department of Microbiology, Faculty of Medicine, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Chennai, India. saravanan@yrgcare.org
Velu
Vijayakumar
V
Nandakumar
Subhadra
S
Madhavan
Vidya
V
Shanmugasundaram
Uma
U
Murugavel
Kailapuri G
KG
Balakrishnan
Pachamuthu
P
Kumarasamy
Nagalingeswaran
N
Solomon
Suniti
S
Thyagarajan
Sadras Panchatcharam
SP
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015897:Comorbidity; D004279:DNA, Viral / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral; D000410:Alanine Transaminase; D001663:Bilirubin