PREVALENCE AND SIGNIFICANCE OF HEPATITIS-C VIREMIA IN CHRONIC ACTIVE HEPATITIS-B

Objectives: To assess the prevalence and significance of HCV infection in patients with chronic active hepatitis B. Methods: We studied clin ical and histological activity in 132 patients with chronic active hep atitis B, 17 of whom were co-infected by HCV. Serum HBV-DNA was determ ined by dot-blot hybridization and polymerase chain reaction (PCR) and serum HCV-RNA was determined by ELISA-2, RIBA-2, and reverse transcri ption PCR (RT-PCR). Results: HBV-DNA was detected by dot-blot in five of 17 (29.4%) patients in the HCV-RNA-positive group and in 64 of 115 (55.6%) in the HCV-RNA-negative group (p < 0.05). The low levels of HB V replication (assessed by PCR) were similar in both groups. Mean leve ls of serum AST, ALT, and gamma-globulin, as well as mean scores of li ver damage, were significantly higher among HCV-RNA-positive patients than among HCV-RNA-negative patients. Conclusions: 1) Concomitant HCV infection occurs frequently in patients with chronic active hepatitis B; 2) co-infection of HBV and HCV is more common in the absence of HBV -DNA detected by dot-blot hybridization; 3) liver disease seems to be more severe in patients with concomitant HBV and HCV infection, even t hough the number of replicative HBV patients was lower in the group of HCV-infected patients. This suggests that the role of HCV is probably important as the cause of persistent liver disease. 4) The detection of HBV-DNA by dot-blot and HCV-RNA by PCR could help to establish whet her HBV, HCV, or both contribute to liver injury.