Viral Hepatitis

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HBV superinfection in HCV chronic carriers: A disease that is frequently severe but associated with the eradication of HCV†

  1. Evangelista Sagnelli1,2,‡,*,
  2. Nicola Coppola1,
  3. Mariantonietta Pisaturo1,
  4. Addolorata Masiello1,
  5. Gilda Tonziello1,
  6. Caterina Sagnelli1,2,
  7. Vincenzo Messina2,
  8. Pietro Filippini1

Article first published online: 23 DEC 2008

DOI: 10.1002/hep.22794

Issue

Hepatology

Hepatology

Volume 49, Issue 4, pages 1090–1097, April 2009

Additional Information

How to Cite

Sagnelli, E., Coppola, N., Pisaturo, M., Masiello, A., Tonziello, G., Sagnelli, C., Messina, V. and Filippini, P. (2009), HBV superinfection in HCV chronic carriers: A disease that is frequently severe but associated with the eradication of HCV. Hepatology, 49: 1090–1097. doi: 10.1002/hep.22794

Author Information

  1. 1

    Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Naples, Italy

  2. 2

    Division of Infectious Diseases, Azienda Ospedaliera Sant'Anna e San Sebastiano di Caserta, Caserta, Italy

  1. ‡

    fax: 081/5666206

*Department of Public Medicine, Section of Infectious Diseases, Second University of Naples, c/o Ospedale Gesù e Maria, Via D. Cotugno 1, 80135 Naples, Italy

  1. †

    Potential conflict of interest: Nothing to report.

  2. ‡

    fax: 081/5666206

Publication History

  1. Issue published online: 27 MAR 2009
  2. Article first published online: 23 DEC 2008
  3. Accepted manuscript online: 23 DEC 2008 12:00AM EST
  4. Manuscript Accepted: 5 DEC 2008
  5. Manuscript Received: 7 AUG 2008

Funded by

  • Legge 5 2005
  • Regione Campania
  • Ricerca Ateneo 2005, 2006, Ministry of Education, University
  • Research of Italy (MIUR), Rome, Italy

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Abstract

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. (HEPATOLOGY 2009.)

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