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Ethnic differences in viral dominance patterns in patients with hepatitis B virus and hepatitis C virus dual infection

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Hepatology. 2011 Mar 21. doi: 10.1002/hep.24308. [Epub ahead of print]

Ethnic differences in viral dominance patterns in patients with hepatitis B

virus and hepatitis C virus dual infection.

Nguyen LH, Ko S, Wong SS, Tran PS, Trinh HN, RT, Ahmed A, Lutchman GA,

Keeffe EB, Nguyen MH.

Stanford University, School of Medicine, Stanford, California, USA; Pacific

Health Foundation, San , California, USA.

Abstract

BACKGROUND AND AIMS: Studies of HBV/HCV dual infection are limited. Most are

small, conducted outside the U.S., and compare dual infection with HCV

monoinfection. The goal of this study was to characterize HBV/HCV dual infection

in a large multiethnic, matched, case-control study of dual infected and

HBV-monoinfected patients at two U.S. centers.

METHODS: Using ICD-9 electronic query and chart review, we identified 115

HBV/HCV dual infection patients with serial HBV DNA, HCV RNA, and ALT levels. As

a control, 115 monoinfected HBV patients were chosen randomly and matched to

cases by age±10 years, gender, Asian vs. non-Asian ethnicity, and study site.

RESULTS: Both groups had similar gender, ethnic, and age distributions: 68%

male, 83% Asian, and age 52±14 years. Median follow-up was 33-38 months. More

monoinfected patients received HBV antiviral therapy than dual infected patients

(43% vs. 24%, P= 0.002). No significant difference was detected between the

proportion of monoinfected vs. dual infected patients with ALT above 40 U/L at

presentation or during follow-up. Dual infection patients exhibited very little

HBV/HCV codominance at baseline and throughout follow up: patients had either

HBV viremia with low or absent HCV RNA or detectable HCV RNA with low or absent

HBV DNA. Asian ethnicity was predictive of HBV dominance after adjusting for

gender, age, and baseline ALT elevation (OR = 7.35, P= 0.01).

CONCLUSION: HBV/HCV dual infected and HBV monoinfected patients generally had

similar clinical characteristics. Asian ethnicity is a major independent

predictor of HBV-dominant disease, and HCV dominance with undetectable HBV DNA

is more common in non-Asians. Larger studies are needed to further characterize

the natural history of HBV/HCV dual infection in Asians and non-Asians.

(Hepatology 2011.).

Copyright © 2011 American Association for the Study of Liver Diseases.

PMID: 21425314 [PubMed - as supplied by publisher]

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