title: Hepatitis B virus and hepatitis C virus co-infection: a therapeutic challenge.
abstract: Hepatitis B virus and hepatitis C virus are the two most common causes of chronic liver disease in the world. Dual infection with hepatitis B virus and hepatitis C virus, whose prevalence is underestimated, is characterized by a more severe liver injury, a higher probability of liver cirrhosis and a higher incidence of hepatocellular carcinoma. Treatment of these patients represents a therapeutic challenge. We report the case of an hepatitis B virus-hepatitis C virus co-infected patient, which particularly illustrates the interactions between these two viruses and therapeutic problems caused by the dual infection. HCV was initially dominant, which indicated a combination therapy by pegylated interferon and ribavirin. This treatment was associated with an early virological response of the HCV but an increase of HBV DNA occurred, requiring the use of a nucleoside analogue. A good response was obtained for the HBV but a relapse of HCV was noted, posing a problem for therapeutic decision.
authors.affiliation: Gastroenterology department, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia. lamine015@yahoo.fr
authors.forename: Lamine
authors.initials: L
authors.lastname: Hamzaoui
authors.forename: Souheil
authors.initials: S
authors.lastname: El Bouchtili
authors.forename: Karima
authors.initials: K
authors.lastname: Siai
authors.forename: Moufida
authors.initials: M
authors.lastname: Mahmoudi
authors.forename: Mohamed Msaddak
authors.initials: MM
authors.lastname: Azzouz
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C413685:entecavir; D006147:Guanine; C100416:peginterferon alfa-2a