title: Serological and molecular expression of Hepatitis B infection in patients with chronic Hepatitis C from Tunisia, North Africa.
abstract: BACKGROUND
  This study reports the prevalence and the viral aspects of HBV infection in HCV-positive patients from Tunisia, a country with intermediate and low endemicity for hepatitis B and C, respectively.
  
  
  RESULTS
  HBV infection was assessed in the serum samples of 361 HCV-positive patients and compared to a group of HCV negative individuals. Serological markers were determined by ELISA tests and HBV DNA by real-time PCR. HBV serological markers were found in 43% and 44% of patients and controls, respectively. However, the serological and molecular expression of HBV infection differed in the two groups: The group of patients included more individuals with ongoing HBV infection, as defined by the presence of detectable HBsAg and or HBV DNA (17% and 12%, respectively). Furthermore, while most of the controls with ongoing HBV infection expressed HBsAg, the majority of HCV and HBV positive patients were HBsAg negative and HBV DNA positive. Genotyping of HCV isolates showed large predominance of subtype 1b as previously reported in Tunisia. Comparison of the replicative status of the two viruses found low HBV viral load in all co-infected patients as compared to patients with single HBV infection. In contrast, high levels of HCV viremia levels were observed in most of cases with no difference between the group of co-infected patients and the group with single HCV infection.
  
  
  CONCLUSIONS
  This study adds to the knowledge on the prevalence and the virological presentation of HCV/HBV dual infection, providing data from the North African region. It shows that, given the local epidemiology of the two viruses, co-infected patients are likely to have low replication levels of HBV suggesting a suppressive effect of HCV on HBV. In contrast, high replication levels for HCV were fond in most cases which indicate that the presence of circulating HBV-DNA does not necessarily influence HCV replication.
authors.affiliation: Laboratory of Clinical Virology, Institut Pasteur, Tunis, Tunisia. bh_samar80@yahoo.fr
authors.forename: Samar Ben
authors.initials: SB
authors.lastname: Halima
authors.forename: Olfa
authors.initials: O
authors.lastname: Bahri
authors.forename: Nadia
authors.initials: N
authors.lastname: Maamouri
authors.forename: Imed
authors.initials: I
authors.lastname: Cheikh
authors.forename: Nissaf Ben
authors.initials: NB
authors.lastname: Alaya
authors.forename: Amel
authors.initials: A
authors.lastname: Sadraoui
authors.forename: Ons
authors.initials: O
authors.lastname: Azaiez
authors.forename: Msaddak
authors.initials: M
authors.lastname: Azouz
authors.forename: Nabyl Ben
authors.initials: NB
authors.lastname: Mami
authors.forename: Henda
authors.initials: H
authors.lastname: Triki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004279:DNA, Viral / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006509:Hepatitis B / Q000453:epidemiology* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014416:Tunisia / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens