HBV superinfection in hepatitis C virus chronic carriers, viral interaction, and clinical course

Authors

  • Evangelista Sagnelli,

    Corresponding author
    1. Division of Infectious Diseases, Azienda Ospedaliera di Caserta, 2nd University of Naples, Naples, Italy
    2. Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Naples, Italy
    • 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. fax: (39) 081-566-6206.
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  • Nicola Coppola,

    1. Division of Infectious Diseases, Azienda Ospedaliera di Caserta, 2nd University of Naples, Naples, Italy
    2. Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Naples, Italy
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  • Vincenzo Messina,

    1. Division of Infectious Diseases, Azienda Ospedaliera di Caserta, 2nd University of Naples, Naples, Italy
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  • Domenico di Caprio,

    1. Division of Infectious Diseases, Azienda Ospedaliera di Caserta, 2nd University of Naples, Naples, Italy
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  • Cecilia Marrocco,

    1. Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Naples, Italy
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  • Anna Marotta,

    1. Division of Infectious Diseases, Azienda Ospedaliera di Caserta, 2nd University of Naples, Naples, Italy
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  • Mirella Onofrio,

    1. Division of Infectious Diseases, Azienda Ospedaliera di Caserta, 2nd University of Naples, Naples, Italy
    2. Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Naples, Italy
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  • Carlo Scolastico,

    1. Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Naples, Italy
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  • Pietro Filippini

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

We enrolled 44 patients with hepatitis B virus (HBV) acute infection, 21 anti-hepatitis C virus (HCV)–positive for at least 1 year (case BC group), 20 anti-HCV–negative (control B group), and 3 with HBV/HCV acute concurrent infection. For each case BC, a subject with chronic HCV infection alone was selected (control C group). At the first observation, 85.7% of patients in case BC group and 85% of those in control B group were HBV-DNA–positive (polymerase chain reaction [PCR]), with a similar trend towards a decrease and negativization in about 20 days; in the case BC group, seroconversion to antibody to hepatitis B e antigen (anti-HBe) was more rapid. HCV-RNA (PCR) was undetectable in all case BC patients but 1, who shortly became negative, whereas 85.7% of subjects in control C group were positive (P < .001). Severe acute hepatitis was more frequent in the case BC group than in the control B group (28.6% vs. 0%, P < .05). Of the 14 patients in the case BC group and of the 16 in the control B group followed up for more than 6 months, 1 in the first and 1 in the second group became hepatitis B surface angiten (HBsAg) chronic carriers. Of the 13 patients in case BC group who recovered, 1 cleared both anti-HCV and HCV-RNA, 6 became HCV-RNA–positive, and 6 remained HCV-RNA–negative. In patients with HBV/HCV acute concurrent infection, HBV-DNA became undetectable in 15 days, and HCV-RNA and anti-HCV became positive at days 30 and 45, respectively; these patients developed HCV-RNA–positive chronic hepatitis. In conclusion, HBV superinfection in chronic HCV carriers has a severe clinical course and strongly and persistently depresses HCV.

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