Impact of acute hepatitis C virus superinfection in patients with chronic hepatitis B virus infection☆

Liaw, Yun–Fan; Chen, Yi-Cheng; Sheen, I‐Shyan; Chien, Rong‐Nan; Yeh, Chau‐Ting; Chu, Chia–Ming

doi:10.1053/j.gastro.2004.01.011

Cited by 221 publications

(188 citation statements)

References 33 publications

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“…Coinfection with HBV and HCV is associated with severe forms of liver disease including fulminant hepatitis [8]. Patients with concurrent HBV and HCV infection have a high propensity to progress toward liver cirrhosis and, compared with monoinfected patients, are at an increased risk of developing hepatocellular carcinoma (HCC) [4,[9][10][11][12]. Notably, viral interference is evident between HBV and HCV.…”

Section: Hbv and Hcvmentioning

confidence: 99%

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Current therapy for hepatitis C or D or immunodeficiency virus concurrent infection with chronic hepatitis B

Chien

2008

Hepatol Int

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Concurrent hepatitis C virus (HCV), hepatitis delta virus (HDV), or human immunodeficiency virus (HIV) infection with chronic hepatitis B virus (HBV) appears to increase the risk of progressive liver disease including liver cirrhosis and hepatocellular carcinoma. There is a 10% prevalence of HCV infection in chronic HBV or HDV infection. Serological evidence of previous exposure to HBV is found in more than 80% of HIVpositive patients in the high risk group. Notably, the most recently acquired virus tends to suppress the pre-existing virus. In chronic HBV infection acquired perinatally or in early childhood, usually HCV is dominant and may suppress or even displace HBV and HDV. Less frequently, HBV or HDV suppresses HCV. It is generally agreed that the dominant virus should be identified in order to make appropriate treatment decisions. Studies with standard interferon (IFN) to treat patients with HCV dominantly dual HBV/HCV infection have showed only limited virological response. But high dose of IFN has been demonstrated with better response rate. Combined ribavirin with standard or pegylated IFN therapy could achieve a sustained HCV clearance rate comparable with those infected with HCV alone. On the contrary, patients with HBV dominantly dual viral infection might indicate more appropriate addition of lamivudine to IFN than ribavirin. Additionally, patients with concurrent infection of HBV and HDV, IFN seems to be the only effective agent. However, the efficacy of IFN is related to the dose. High dose of IFN [9 MU tiw (thrice per week)] and longer treatment duration (at least 2 years) have been shown to achieve adequate virological response. In patients with concurrently infected HBV and HIV, anti-HBV therapy should be considered for all patients with evidence of liver disease, irrespective of the CD4 cell count. In patients not requiring antiretroviral therapy, HBV therapy should be preferentially based on IFN, adefovir, or telbivudine. In contrast, in patients with CD4 cell counts \350 cells/ll or those already on antiretroviral therapy, agents with double anti-HBV and anti-HIV activity are preferred. At present, the evidence of therapeutic efficacy is not sufficient to make a recommendation in treating patients with dual HBV/HCV or HBV/HDV or HBV/HIV infection. Further studies of the well-designed, larger scale are needed to elucidate the role of different regimens or combination in the treatment of dual viral infection.

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Section: Hbv and Hcvmentioning

confidence: 99%

“…Notably, viral interference is evident between HBV and HCV. Mostly, HCV exerts a suppressive effect on HBV and may enhance seroclearance of HBV antigens or even replace the preexisting virus as the agent for continuing hepatitis [4,10,12,13]. As the newcomer, HBV may also suppress the preexisting HCV [4,14].…”

Section: Hbv and Hcvmentioning

confidence: 99%

Current therapy for hepatitis C or D or immunodeficiency virus concurrent infection with chronic hepatitis B

Chien

2008

Hepatol Int

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“…Furthermore, some studies showed that the rate was 11% (18) and 16% (19) in the United States, 8% in Portugal (20), and 25% among patients with cirrhosis and hepatocellular carcinoma in Spain (21). The main concern respecting HBV/HCV co-infection is the synergic effects of HBV and HCV infections can result in more severe liver damage (22,23). Moreover, some studies reported that HBV/HCV co-infection not only increases the risk of hepatocellular carcinoma but also is associated with a higher rate of mortality caused by liver diseases (12,24).…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Hepatitis B and C Virus Co-Infection Among a Group of Iranian Population

2017

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Background: The risks of advanced liver disease, cirrhosis, and liver cancer among patients with hepatitis B and C virus co-infection are greater than in patients with either hepatitis B or hepatitis C virus infection. Objectives: The present study sought to assess the prevalence of hepatitis C virus infection among individuals with hepatitis B surface antigen (HBsAg) seropositivity in Mashhad, the largest city in the northeast of Iran. Methods: This cross-sectional descriptive-analytical study was conducted in 2017 on 284 individuals with HBsAg seropositivity who referred from April 2016 to March 2017 to the Central Diagnostic Laboratory of the Academic Center for Education, Culture, and Research, Mashhad, Iran. Commercially available enzyme-linked immunosorbent assay kits were used for detection of hepatitis C virus. Moreover, real-time reverse transcriptase-polymerase chain reaction quantification test was performed for individuals with hepatitis C virus antibody.

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“…The declining incidence is attributed to the increased vaccination for HBV infection, the improved hygienic conditions, at least in European countries, and the prophylactic measures for HIV infection. HDV coinfection is characterized by accelerated progression of liver disease and greater incidence of cirrhosis than HBV monoinfection [44,53]. Apart from the previously mentioned study of Gaeta, a Taiwanese study of acute HCV or HDV infection in HBsAg + patients demonstrated that 48% of those HBV-HCV coinfected patients developed cirrhosis, compared with 21% of Review those with HBV-HDV coinfection [53].…”

Section: Hdv Coinfectionmentioning

confidence: 99%

Treatment of special populations with chronic hepatitis B infection

Rapti¹,

Hadziyannis²

2011

Expert Review of Gastroenterology & Hepatology

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Impact of acute hepatitis C virus superinfection in patients with chronic hepatitis B virus infection☆

Cited by 221 publications

References 33 publications

Current therapy for hepatitis C or D or immunodeficiency virus concurrent infection with chronic hepatitis B

Current therapy for hepatitis C or D or immunodeficiency virus concurrent infection with chronic hepatitis B

The Prevalence of Hepatitis B and C Virus Co-Infection Among a Group of Iranian Population

Treatment of special populations with chronic hepatitis B infection

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