CHARACTERISTICS OF PATIENTS WITH DUAL INFECTION BY HEPATITIS-B AND HEPATITIS-C VIRUSES

Background/Aims: The purpose of this study was to compare the epidemio logical, biochemical, virological and histological characteristics of patients with chronic hepatitis B and C with those of patients sufferi ng from chronic hepatitis C alone, Methods: Twenty-three patients with chronic hepatitis C, who were anti-HCV positive and HBs antigen posit ive, were studied and subdivided into two groups according to the pres ence or absence of HBV DNA replication, They were compared to 69 age- and sex-matched patients with chronic hepatitis who were anti-HCV posi tive and HBs antigen negative, All patients were HCV RNA positive by P CR, anti-HIV negative and anti-HDV negative, HBV DNA and HCV RNA were detected in serum by means of a branched DNA assay and PCR, The HCV se rotypes were determined by the Chiron Riba HCV serotyping SIA techniqu e, The histological characteristics included the Knodell score, Result s: Epidemiological, biochemical and virological parameters were not di fferent between the two groups, Only the prevalence of cirrhosis was g reater in chronic hepatitis B and C patients than in patients with chr onic hepatitis C alone (p=0.01), Among chronic hepatitis B and C patie nts, HCV RNA level was significantly lower in HBV DNA positive than in HBV DNA negative patients (p=0.01), Indeed, histological lesions were more severe in HBV DNA positive than in HBV DNA negative patients, in cluding prevalence of cirrhosis (p=0.01), Knodell score (p=0.05) and, among the latter, piecemeal necrosis (p=0.01) and fibrosis (p=0.05), T he characteristics of patients with dual infection did not differ acco rding to the mode of contamination and duration of HBV disease, except for a shorter duration in patients contaminated by drug abuse than in other patients. Conclusions: These results suggest that HBV DNA repli cation inhibits HCV RNA replication in patients with chronic active he patitis B and C but increases the severity of histological lesions.