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HBV superinfection in HCV chronic carriers: A disease that is frequently severe but associated with the eradication of HCV
Author(s) -
Sagnelli Evangelista,
Coppola Nicola,
Pisaturo Mariantonietta,
Masiello Addolorata,
Tonziello Gilda,
Sagnelli Caterina,
Messina Vincenzo,
Filippini Pietro
Publication year - 2009
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.22794
Subject(s) - superinfection , medicine , hbsag , hepatitis b virus , hepatology , immunology , hepatitis b , gastroenterology , viral load , hepatitis c virus , liver disease , hepatitis c , virus , virology
The impact of hepatitis B virus (HBV) superinfection in hepatitis C virus (HCV) chronic carriers was evaluated in a long‐term follow‐up study on 29 chronic anti‐HCV carriers with acute hepatitis B (AVH‐B) (Case group BC) and 29 anti‐HCV negative patients with AVH‐B (Control group B), pair‐matched for age (±5 years), sex, and risk factors for the acquisition of HBV infection. Patients in Case group BC and those in Control group B showed similar initial HBV viral load and a similar trend of becoming negative for HBV‐DNA. AVH‐B showed a severe course more frequently in Case group BC than in Control group B (34.5% versus 6.9%, P < 0.05). Of the 28 patients in Case group BC alive at the end of the acute illness (one death from liver failure), 24 were followed up for 2‐6 years, median 5 years: 22 patients became HBsAg‐negative and two progressed to HBsAg‐positive chronic hepatitis. HCV‐RNA was undetectable in all patients during AVH‐B; in the 24 patients with a long‐term follow‐up, HCV‐RNA was detected in seven (29.2%) after 1 year, in 14 (58.3%) after 2 years, and in 18 (75%) after 3‐6 years. The six patients who eradicated chronic HCV infection, compared with 18 showing reactivation of HCV replication, had higher values of aspartate aminotransferase and alanine aminotransferase and a higher prevalence of cases with severe AVH‐B (83.3% versus 22.2%, P < 0.05). Conclusions: Although it can be life‐threatening, HBV superinfection in HCV chronic carriers may lead to clearance of chronic HCV infection, especially in patients with severe AVH‐B. (H EPATOLOGY 2009.)