Article

Hepatitis B Virus Infection Among American Patients with Chronic Hepatitis C Virus Infection: Prevalence, Racial/Ethnic Differences, and Viral Interactions

NYU Langone Medical Center, New York, New York, United States
Hepatology (Impact Factor: 11.06). 03/2010; 51(3):759-66. DOI: 10.1002/hep.23461
Source: PubMed

ABSTRACT

Little is known about hepatitis B virus (HBV) infection among patients with chronic hepatitis C virus (HCV) infection in the United States. We prospectively enrolled 1,257 patients with chronic HCV infection from two medical centers in New York City. A total of 61.5% (95% confidence interval, 58.8%-64.2%) had evidence of prior exposure to HBV (hepatitis B core antibody-positive), whereas 5.8% (95% confidence interval, 4.5%-7.1%) had dual infection with HBV (hepatitis B surface antigen-positive). Multivariable logistic regression analysis identified age <40 years, Asian race, injection drug use, and a greater number of lifetime sexual partners as independent risk factors for HBV-HCV dual infection. Liver biopsy results in 26 HBV-HCV-infected and 658 HCV-monoinfected patients showed that stage 3 or 4 fibrosis was significantly more common in those with HBV-HCV dual infection (84.6% versus 29.9%; P < 0.001). Patients infected with HBV and HCV had significantly lower median HCV RNA levels (1.3 versus 4.5 x 10(6) copies/mL; P < 0.001) and were less likely to have HCV RNA levels > or =5 x 10(6) copies/mL (12.3% versus 45.4%; P < 0.001) than those who had HCV monoinfection. All five patients with HBV-HCV dual infection who had undetectable HBV DNA levels had HCV RNA levels > or =5 x 10(6) copies/mL. Conclusion: American patients with chronic HCV infection should be tested for HBV, especially younger patients, Asians, injection drug users, and those with an increased number of lifetime sexual partners. The presence of severe liver disease and HBV-HCV viral interactions in patients with dual infection necessitates careful but aggressive clinical management, although the optimal strategy remains to be determined.

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    • "Coinfected patients commonly have lower HBV DNA levels, and decreased hepatic expression of HBsAg and HBV core antigen compared to HBV monoinfected patients234567. In addition, in vitro studies have also shown evidence that HCV can suppress HBV replication[2]. This has led to the hypothesis of reciprocal interaction between viruses where HBV replication is inhibited by HCV. Hence, the potential for reactivation of HBV following HCV treatment has long been a concern. "
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    Full-text · Article · Jul 2015 · Journal of Medical Case Reports
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    • "Panama is a country with a high diversity of growing foreign communities; the Chinese population is a large example (INEC 2011). In the metropolitan areas of several developed cities (Lavanchy 2004, Pollack et al. 2006, Bini & Perumalswami 2010, Kallman et al. 2011), there is growing evidence of a high prevalence of HBV in Asian populations, but little is known regarding the molecular characteristics of the virus in these populations . To successfully implement a universal HBV vaccination program in Central American countries, it will be necessary to study the prevalence and molecular characteristics of the HBV genotypes that infect the risk groups in the region. "
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    • "In the present study, the 5-year cumulative incidence of HBsAg seroconversion was 8.3%. The fact that a substantially higher rate of HBsAg seroconversion was found in our study as compared to studies of CHB monoinfection suggests that HCV superinfection may interact with HBV and enhance the appearance of anti-HBs after loss of HBsAg [38], [39]. "
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    Full-text · Article · Jun 2011 · PLoS ONE
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