The inverse relationship between chronic HBV and HCV infections among injection drug users is associated with decades of age and drug use

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-4605, USA.
Journal of Viral Hepatitis (Impact Factor: 3.91). 06/2008; 15(9):690-8. DOI: 10.1111/j.1365-2893.2008.01005.x
Source: PubMed


Infection with hepatitis C virus (HCV) may suppress co-infection with hepatitis B virus (HBV) during acute or chronic HBV infection. We examined relationships between HBV infection, HCV infection and other factors among injection drug users (IDUs) with antibodies to both viruses. Participants enrolled in a cross-sectional study during 1998-2000 were considered to have been infected with HBV if they had core antibody, to be chronically infected if they had hepatitis B surface antigen (HBsAg), to have been infected with HCV if they had HCV antibody and to be chronically infected if they had HCV RNA. Among 1694 participants with antibody to both viruses, HBsAg prevalence decreased with increasing age among those positive for HCV RNA [from 4.55% in those 18-29 years to 1.03% in those >or=50 years old (P(trend) = 0.02)], but not among those who were negative for HCV RNA. Chronic HBV infection was less common overall among those with chronic HCV infection (odds ratio [OR], 0.25; P < 0.0001), but this inverse relationship was much stronger in the oldest (>50 years; OR = 0.15) than the youngest (18-29 years; OR = 0.81) participants (P(trend) = 0.03). Similar results were obtained when duration of injection drug use was substituted for age (P(trend) = 0.05). Among IDUs who have acquired both HBV and HCV, chronic HBV infection is much less common among those with chronic HCV infection, but this inverse relationship increases markedly with increasing years of age and injection drug use. Co-infection with HCV may enhance the resolution of HBsAg during the chronic phases of these infections.

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Available from: Michael P Busch, May 11, 2015
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    • "Another explanation is that the TS study provided HCV testing for participants from 1998 to 2001, and many in the 2005 TS sample had participated in the earlier cross-sections. HCV prevalence among IDUs in the TS study during those years was 91%.34 "
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    • "The prevalence of HIV (15% in 2002), HCV (91% in 2000), HBV (81% in 2000), and soft tissue infections (32% in 1997) is high among IDUs in San Francisco (Bluthenthal et al 2007; Binswanger et al 2000; Tseng et al 2008). Public drug use is a perennial topic in local elections and the press. "
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    • "It should also be noted that that we defined a positive HCV RNA result on the basis of an assay with a detection limit of 2500 copies/ml. In another analysis based on these test results, Tseng et al [24] found that the relative risks in UHS for previously reported predictors of chronic HCV infection (i.e., older age, African ancestry, presence of HBsAg, HIV infection) were very consistent with studies of 'HCV clearance' [25]. We are confident, therefore, that our study design is able to detect true differences in HCV outcome. "
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