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Virologic and clinical expressions of reciprocal inhibitory effect of hepatitis B, C, and delta viruses in patients with chronic hepatitis
Author(s) -
Sagnelli Evangelista,
Coppola Nicola,
Scolastico Carlo,
Filippini Pietro,
Santantonio Teresa,
Stroffolini Tommaso,
Piccinino Felice
Publication year - 2000
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1053/jhep.2000.19288
Subject(s) - hbsag , cirrhosis , medicine , hepatitis b virus , hepatitis b , virology , group a , group b , gastroenterology , immunology , virus
We studied 648 hepatitis B surface antigen (HBsAg)‐ and/or anti–hepatitis C virus (HCV)‐positive patients to evaluate the virologic and clinical characteristics of multiple hepatitis viral infection. We defined as Case B‐C an HBsAg/anti‐HCV positive patient and as Case b‐C an anti‐HCV/anti‐HBc‐positive, HBsAg/anti‐HBs–negative patient. For each Case B‐C we scheduled as Control‐B an HBsAg positive and anti‐HCV negative patient and as Control‐C an HBsAg/anti‐HBs/anti–hepatitis B core antigen (HBc)‐negative and anti‐HCV–positive patient. Control group C was used as the control also for Case group b‐C. Serum HBV DNA by molecular hybridization was found more frequently in Control group B (54% of 161 patients) than in Case group B‐C (35.7% of 84, P < .01). The prevalence of HBV wild type was similar in Case group B‐C (14.3%) and in Control group B (17.4%), whereas the e‐minus strain was less frequent in Case group B‐C (10.7% vs. 33%; P < .01). HBV DNA by polymerase chain reaction (PCR) was detected in 40.8% of 71 patients in Case group b‐C. HCV RNA was detected more frequently in Control group C (90.7% of 130 patients) than in Case group B‐C (65.2% of 69, P < .0001). Moderate or severe chronic hepatitis or cirrhosis were more frequent in Case group B‐C (62.9% of 65 patients) than in Control group B (46.7% of 90, P < .05) or C (40.8% of 98, P < .005), and in Case group b‐C (71.1% of 76) than in Control group C. Thus, in multiple hepatitis we observed a reciprocal inhibition of the viral genomes and a more severe liver disease. In Case group b‐C, serum HBV DNA was frequent and the clinical presentation was severe.