[Influence of previous hepatitis B virus infection on liver fibrosis in patients with chronic hepatitis C: a retrospective case series evaluation].
BACKGROUND
Hepatitis C is a major cause of liver disease worldwide. Its evolutionary course is dynamics and may be influenced by several cofactors. Among them, previous hepatitis B virus infection (anti-HBcAg [+] and HBsAg [-]) has been associated with worse histological and therapeutic prognosis. This study had the objective of independently assessing the relationship between previous hepatitis B infection and liver fibrosis in patients with chronic hepatitis C.


METHODS
The medical records of patients chronically infected with the hepatitis C virus who had been seen consecutively during a one-year period at the infectious and parasitic diseases outpatient clinic of HC FMUSP were retrospectively reviewed in relation to epidemiological, clinical and histological data. Analysis on the independence of the previous hepatitis B infection was performed using the statistical model of multivariate logistic regression. Detection of anti-HBcAg was taken to be the independent variable. The outcome was taken to be grade 3 and 4 histopathological abnormality (septa with nodule formation and cirrhosis).


RESULTS
145 subjects were evaluated in this study. 47.2% of them were anti-HBcAg (+). The main risk factor for infection was blood and blood derivative transfusion (35.9%). Findings of anti-HBcAg (+) were not related to advanced liver fibrosis, although piecemeal necrosis has been found frequently in patients with this serological marker.


CONCLUSIONS
Previous hepatitis B infection does not seem to increase the structural liver damage triggered by chronic hepatitis C virus infection, after statistical control for other co-factors capable to impact the natural history of this infection.
Lisboa Neto
Gaspar
G
Departamento de Doenças Infecciosas e Parasitárias, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP. glneto@usp.br
Tengan
Fatima Mitiko
FM
Cavalheiro
Norma de Paula
Nde P
Barone
Antonio Alci
AA
D000293:Adolescent; D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
D006512:Hepatitis B Core Antigens