Clinical and histological impact of previous hepatitis B virus infection in patients with chronic hepatitis C

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http://www3.interscience.wiley.com/journal/120126024/abstract?CRETRY=1 & SRETRY=0

Liver International

Volume 29 Issue 1, Pages 133 - 140

Published Online: 27 May 2008

CLINICAL STUDIES

Clinical and histological impact of previous hepatitis B virus infection in

patients with chronic hepatitis C

o J. Carvalho-Filho 1 , Leonardo de Lucca Schiavon 1 , Janaína L.

Narciso-Schiavon 1 , na P. Sampaio 1 , Valéria P. Lanzoni 2 , L.

Gomes Ferraz 1 and E. Benedito Silva 1

1 Division of Gastroenterology, Hepatitis Section, Federal University of Sao

o, Sao o, Brazil

2 Department of Pathology, Federal University of Sao o, Sao o, Brazil

Correspondence

Dr o J. Carvalho-Filho, MD, Avenida Onze de Junho, 685/158, Vila

Clementino, São o, SP, Brazil, 04041-052

Tel: +55 11 5576 4050

Fax: +55 11 5576 4050

e-mail: roberto.jcf@...

ABSTRACT

Background: Recent reports suggest that hepatitis C virus (HCV) carriers with

serological markers of prior hepatitis B virus (HBV) infection have more

advanced liver fibrosis, irrespective of HBV-DNA detection.

Aims: We sought to assess the prevalence and impact of previous HBV infection in

patients with HCV chronic infection.

Methods: This cross-sectional study included hepatitis B surface antigen- and

human immunodeficiency virus-negative subjects with positive HCV-RNA. All

patients had prior parenteral exposure as the probable source of HCV infection.

Serum samples were tested for HBV-DNA using a commercial assay. The METAVIR

system was used for histological analysis.

Results: One-hundred and eleven patients were evaluated. Thirty-one out of 111

patients (28%) tested positive for antihepatitis B core antigen (anti-HBc).

HBV-DNA was not detected in any sample. Anti-HBc-positive patients showed higher

histological grading, staging and a higher fibrosis progression rate. By

multivariate analysis, anti-HBc-positivity was predictive of moderate to severe

activity [odds ratio (OR)=3.532; P=0.032] and significant hepatic fibrosis

(OR=3.364; P=0.017). After approximately 20 years of infection, advanced liver

fibrosis (F3/F4) can be expected in 13% of anti-HBc-negative subjects who

acquired HCV before the age of 30 and in 57% of those anti-HBc-positive patients

who were infected by HCV after 30 years of age (P