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

Abstract

The impact of hepatitis B virus (HBV) superinfection in hepatitis C virus (HCV) chronic carriers was evaluated in a longC hronic hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection is characterized by a reciprocal inhibition of the viral genomes, a severe clinical presentation, and an infrequent response to antiviral treatment. [1][2][3][4][5][6][7][8][9] This reciprocal inhibition was observed also in acute HBV/HCV coinfection. 10,11 Models of HBV and HCV superinfection have also been investigated. A marked inhibition of the preexisting viral replication has been observed both in HBV chronic carriers with superimposed acute hepatitis C 12-15 and in HCV chronic carriers with HBV superinfection, [16][17][18] both models being frequently characterized by a severe clinical course. 15,18 In a study on HBV superinfection in HCV chronic carriers, the inhibition exerted by HBV on the HCV genome persisted during a follow-up of 1 year in half of the patients, 18 but a comprehensive evaluation of the virus interaction and clinical outcome was hampered by the lack of information on HCV replication before HBV superinfection by the low sensitivity of the HBV-DNA assay used and the short follow-up period.The present article describes a case-control study performed on 29 HCV chronic carriers with HBV superinfection and 29 anti-HCV negative pair-matched controls who developed acute hepatitis B in the same period. Most of the patients with HBV superinfection had been observed for at least 1 year before the onset of acute hepatitis

Hepatitis C virus infection in the general population: A large community-based study in Mianyang, West China

“…Among the HBsAg-positive patients, the HCV concurrent infection rate was 0.51%, which is lower than that reported in other literature (29,30). Though there was a small amount of HBV and HCV coinfection, patients with dual HBV/HCV infection have a higher risk of progression to cirrhosis and decompensated liver disease than those in patients with monoinfection (31,32). So it is important for early detection and treatment of coinfection.…”

Coinfection With Hepatitis B and Hepatitis C Virus: New Insights of Treatment in the Era of Direct Acting Antivirals.

“…In either case, the problem is that coinfection can result in severe liver disease progression such as cirrhosis and HCC. [13,23,26,27] Overall more than 90% of adults with acute HBV infection develop icteric hepatitis as a result of an appropriate immune response followed by a spontaneous resolve of the virus, and develop antibodies against hepatitis B virus (anti-hepatitis B surface (anti-HBs)) [28], [29] Few patients develop chronic HBV hepatitis and remain surface antigen (HBsAg) positive. In contrast, most adults exposed to hepatitis C virus develop an acute hepatitis without icterus and approximately 80 to 85% develop chronic infection.…”

“…Patients may resolve hepatitis B virus or hepatitis B infection may become silent (occult HBV infection) [31] and develop chronic HCV hepatitis; [32] they may resolve hepatitis C and develop chronic HBV hepatitis; [26] they may resolve both viruses; or they may develop chronic infection with both hepatitis B and C viruses. [13] Clinical, serological and virological characteristics of these infectious senarios are outlined in Table 1. [33] in order to evaluate viral loads before initiating any treatment.…”

“…[13] This inverse relationship of the replicative patterns of the two viruses suggests direct or indirect (i.e., mediated by host immune responses) viral interference. [14], [15], [16] The primary concern with chronic HBV and HCV co-infection is that co-infection seems to result in more severe liver disease progression than monoinfections, [13], [17], [18] with an increased risk of hepatocellular cancer (HCC) [19], [ 20], [21] and of fulminant hepatitis. [22] New findings confirmed that HBV/HCV coinfected patients may experience more rapid progression of severe liver disease compared to those with hepatitis B alone although similar data for Asian and African patients with the highest prevalence of HBV infection worldwide are still missing.…”

Chronic Hepatitis B Reactivation Subsequent to Chronic Hepatitis C Treatment: A Case Report

“…Hepatitis B infection is seen as an acute or chronic infection form and usually begins with a general-ill status, while hepatitis C infection is seen usually as an asymptomatic chronic infection leading to severe liver damage over the years [3]. Globally, an estimated 257 million and 71 million people are living with HBV and HCV [4,5].…”