LONG-TERM FOLLOW-UP OF HEPATITIS-B VIRUS AND HEPATITIS-C VIRUS REPLICATIVE LEVELS IN CHRONIC HEPATITIS PATIENTS COINFECTED WITH BOTH VIRUSES

Dual infection with hepatitis B and C viruses is often encountered in endemic areas of both viruses. However, understanding of the clinical and virological im plications is limited. The aim of this study was to investigate the role of each virus in liver injury and the interactio n between the two viruses in dual infection with hepatitis B and C vir uses. Three patients who had chronic infection with both hepatitis B a nd C viruses were examined, and a longitudinal study of both serum hep atitis B virus DNA and hepatitis C virus RNA levels over 4 years was u ndertaken. The results were correlated with serum alanine aminotransfe rase levels. Serum alanine aminotransferase values showed a relationsh ip with hepatitis B virus replicative levels, but not with hepatitis C virus replicative levels in all 3 patients. Serial changes of replica tive levels of both viruses were studied, and it was found that hepati tis C virus replicative levels were enhanced after the decline of hepa titis B virus replication in 1 of the 3 patients. In the remaining 2 p atients, a transient rise of hepatitis C virus replicative levels in a ssociation with a decrease of hepatitis B virus replication was also o bserved during part of the follow-up period. These findings indicate t hat hepatitis B virus may play a dominant etiological role in liver in jury, and that a suppressive action between hepatitis B and C viruses may occur in dual infection with both viruses. (C) 1995 Wiley-Liss, In c.