Article

Serological and molecular expression of Hepatitis B infection in patients with chronic Hepatitis C from Tunisia, North Africa

Laboratory of Clinical Virology, Institut Pasteur, Tunis, Tunisia.
Virology Journal (Impact Factor: 2.18). 09/2010; 7(1):229. DOI: 10.1186/1743-422X-7-229
Source: PubMed

ABSTRACT

This study reports the prevalence and the viral aspects of HBV infection in HCV-positive patients from Tunisia, a country with intermediate and low endemicity for hepatitis B and C, respectively.
HBV infection was assessed in the serum samples of 361 HCV-positive patients and compared to a group of HCV negative individuals. Serological markers were determined by ELISA tests and HBV DNA by real-time PCR. HBV serological markers were found in 43% and 44% of patients and controls, respectively. However, the serological and molecular expression of HBV infection differed in the two groups: The group of patients included more individuals with ongoing HBV infection, as defined by the presence of detectable HBsAg and or HBV DNA (17% and 12%, respectively). Furthermore, while most of the controls with ongoing HBV infection expressed HBsAg, the majority of HCV and HBV positive patients were HBsAg negative and HBV DNA positive. Genotyping of HCV isolates showed large predominance of subtype 1b as previously reported in Tunisia. Comparison of the replicative status of the two viruses found low HBV viral load in all co-infected patients as compared to patients with single HBV infection. In contrast, high levels of HCV viremia levels were observed in most of cases with no difference between the group of co-infected patients and the group with single HCV infection.
This study adds to the knowledge on the prevalence and the virological presentation of HCV/HBV dual infection, providing data from the North African region. It shows that, given the local epidemiology of the two viruses, co-infected patients are likely to have low replication levels of HBV suggesting a suppressive effect of HCV on HBV. In contrast, high replication levels for HCV were fond in most cases which indicate that the presence of circulating HBV-DNA does not necessarily influence HCV replication.

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    • "Our research shows a very low prevalence (two cases among 23 578 personts tested) of hepatitis co-infection comparing with Tunisia (5%) and Egypt (22.5%) [28,29], these results indicate that the HBV positive patients investigated herein do not have an increased risk of exposure to HCV infection. Although this small sample size of reactive cases does not allow data to be compared with other reports, one Italian study found that rates of dual infection increased with age, and was more common in patients over 50 years of age [30]. "
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