title: Virologic and histologic characterisation of dual hepatitis B and C co-infection in Egyptian patients.
abstract: OBJECTIVE
  Data about dual hepatitis C (HCV) and B (HBV) co-infection are still scarce, especially in endemic areas such as Egypt. Therefore, we aimed to characterise the virologic and histologic pattern of dual B/C co-infection in a tertiary care centre in Egypt.
  
  
  METHODS
  After obtaining approval from the review board, a retrospective design to evaluate the data registry between January 2009 and December 2012 of patients with dual HCV and HBV seropositivity (BC-group) at the Viral Hepatitis Unit in Ministry of Health and Assiut University Hospital, Egypt was conducted. Data for hepatitis B e antigen (HBe-Ag) and anti-HB core status, anti-hepatitis delta virus (anti-HDV), HBV-DNA and HCV-RNA assays and liver biopsy (METAVIR scoring) results were collected. Two other matched groups of mono-HCV (C-group) and HBV (B-group) were selected as controls. All patients were naive for antiviral therapy.
  
  
  RESULTS
  A total of 3300 patients were enrolled. Dual infection was observed in 25 (0.7%) patients (all males, mean=35.2±10.2years). Four patients (16%) were HBe-Ag-positive. Six (24%) patients were HBV-DNA-negative and all were positive for HCV RNA. Between groups, raised alanine aminotransferase (ALT) was found in 76%, 41.7% and 49.2% of the BC, B and C groups, respectively (p=0.023). HBV DNA >2000IUml(-1) was more in the B-group than in the BC-group (63.9% vs. 36%; p=0.042) and HCV RNA >800,000IUml(-1) was more in the BC-group than in the C-group (28% vs. 12.3%; p=0.009). Histologically, there is no statistical significant difference between the three groups.
  
  
  CONCLUSIONS
  Dual hepatitis B/C infection is not uncommon and their virologic and histologic profile is modest. Further evaluation with regard to treatment and long-term follow-up is warranted.
authors.affiliation: Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt. Electronic address: doc_mekky0000@yahoo.com.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Mekky
authors.affiliation: Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt.
authors.forename: Ahmad Medhat
authors.initials: AM
authors.lastname: Nasr
authors.affiliation: Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt.
authors.forename: Medhat A
authors.initials: MA
authors.lastname: Saleh
authors.affiliation: Viral Hepatitis Management Unit, Ministry of Health, Assiut, Egypt.
authors.forename: Nasr K
authors.initials: NK
authors.lastname: Wasif
authors.affiliation: Viral Hepatitis Management Unit, Ministry of Health, Assiut, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Khalaf
authors.affiliation: Viral Hepatitis Management Unit, Ministry of Health, Assiut, Egypt.
authors.forename: Hany
authors.initials: H
authors.lastname: Aboalam
authors.affiliation: Viral Hepatitis Management Unit, Ministry of Health, Assiut, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Haredy
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D060085:Coinfection / Q000097:blood / Q000473:pathology / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D004534:Egypt; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006509:Hepatitis B / Q000097:blood / Q000473:pathology / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000097:blood / Q000473:pathology / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D012367:RNA, Viral
keywords: ALT; Co-infection; Dual; Egypt; HBV; HBs-Ag; HCC; HCV; PCR; alanine aminotransferase; hepatitis B virus; hepatitis B-surface antigen; hepatitis C virus; hepatocellular carcinoma; polymerase chain reaction