Patients with Both Hepatitis B and C: Look for Cirrhosis


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Carriers of both hepatitis B (HBV) and C virus (HCV) are more often cirrhotic than patients who are positive for anti-HCV only. So say the authors of this prospective, case-control study from Italy. However, this relationship is significant only when the infection has been diagnosed via polymerase chain reaction (PCR) analysis of the serum and liver.

The authors collected serum samples and performed liver biopsies on 19 patients who were positive for both hepatitis B surface antigen (HBsAg) and anti-HCV antibody. They compared this group with 38 matched controls who were anti-HCV-positive only. All subjects had had elevated alanine aminotransferase (ALT) levels for more than 6 months prior to joining the study. The investigators evaluated HBV and HCV infections using standard serology and PCR.

Chronic active hepatitis was present in 7 and cirrhosis in 12 patients who were positive for both HBsAg and anti-HCV. Among patients who were anti-HCV-positive only, 20 had chronic hepatitis and 18 cirrhosis. Although a higher percentage of patients with double infection had cirrhosis compared with single-infection patients, the difference was not statistically significant.

PCR analysis, however, resulted in reclassification of 16 patients (2 who had chronic active hepatitis and 14 who had cirrhosis) from the control group to the HBsAg-positive and anti-HCV-positive group. This change resulted in a highly significant correlation between double infection and the presence of cirrhosis: 24 of 35 patients (69%) with double infection had cirrhosis, compared with only 4 of 22 (18%) who had isolated HCV infection. Chronic active hepatitis was predominant in patients with HCV infection only.
~ by Villa E, Grottola A and Buttafoco P

Villa E, Grottola A, Buttafoco P, et al. Evidence for hepatitis B virus infection in patients with chronic hepatitis C with and without serological markers of hepatitis B, Dig Dis Sci (Jan.) 1995; 40:8- 13.

Copyright 1995 by Advanstar Communications Inc.
Shields, John D.-Green, Robert-Jay-et al, Patients with both hepatitis B and C: Look for cirrhosis.., Vol. 63, Modern Medicine, 06-01-1995, pp 54.

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