Long-term outcome of hepatitis B and hepatitis C virus co-infection and single HBV infection acquired in youth.
Co-infection with HBV and HCV seems to be associated with more severe liver disease in retrospective and cross-sectional studies in adults, but no data are available when co-infection is acquired in youth. The long-term outcome of infection acquired in youth was assessed in patients co-infected with HBV and HCV and in patients with HBV infection only. Twenty-seven patients with HBV and HCV co-infection and 27 patients infected with HBV only were enrolled. Seventy-six per cent of the patients were treated with alpha-interferon for 1 year. After a median follow-up of 23 years, the annual progression rate of fibrosis was 0.07 in patients co-infected with HBV and HCV, and in those infected with HBV it was 0.07 and 0.11 (P < 0.004) for HBe and anti-HBe-positive patients, respectively. In co-infected patients, the development of cirrhosis was observed in 2 (7.4%) and of hepatocellular carcinoma (HCC) in 1 (3.7%), while in those with HBV, cirrhosis appeared in one patient (3.7%). Alcohol intake (OR = 9.5 +/- 1.2; 95% CI = 6.6-13.9; P < 0.0001) was independently associated with cirrhosis and HCC. alpha-interferon showed no efficacy during treatment, but the treated group showed higher HCV RNA clearance during post-treatment follow-up. Co-infection with HBV and HCV and single HBV infection acquired in youth showed a low rate of progression to liver fibrosis, no liver failure, and low development of HCC during a median follow-up of 23 years (range 17-40).
Department of Internal Medicine and Hepatology, Second University of Naples, Naples, Italy. rosa.zampino@unina2.it
Rosa
R
Zampino
Aldo
A
Marrone
Antonietta
A
Merola
Barbara
B
Trani
Grazia
G
Cirillo
Peter
P
Karayiannis
Nicola
N
Coppola
Rosario
R
Zappalà
Riccardo
R
Utili
Giuseppe
G
Ruggiero
Luigi E
LE
Adinolfi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000998:Antiviral Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005355:Fibrosis; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000209:etiology; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D016898:Interferon-alpha