Relevance of inapparent coinfection by hepatitis B virus in alpha interferon-treated patients with hepatitis C virus chronic hepatitis

✍ Scribed by Zignego, Anna Linda; Fontana, Rossana; Puliti, Silvia; Barbagli, Susanna; Monti, Monica; Careccia, Grazia; Giannelli, Francesca; Giannini, Carlo; Buzzelli, Giampiero; Brunetto, Maurizia Rossana; Bonino, Ferruccio; Gentilini, Paolo

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 191 KB
• Volume: 51
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/(sici)1096-9071(199704)51:4<313::aid-jmv9>3.0.co;2-8

✦ Synopsis

The aim of the study was to investigate whether an ''inapparent'' coinfection by hepatitis B virus (HBV) in anti-HCV-positive chronic liver disease patients may influence interferon (IFN) response. Fourteen anti-HCV-positive, hepatitis B surface antigen (HBsAg)-negative but serum HBV-DNA-positive patients and 111 anti-HCV-positive, HBsAg-negative, and HBV-DNA-negative patients with chronic hepatitis were treated with 3 MU of recombinant ␣-2a IFN 3/week for 1.2 months. Serum HBV-DNA and HCV-RNA were determined before treatment, after 6-12 months, and at the time of alanine aminotransferase (ALT) flare-up by HBV polymerase chain reaction (PCR) and HCV PCR, respectively. IgM anti-HBc were tested using the IMx Core-M assay (Abbott Laboratories, North Chicago, IL). By the end of treatment, ALT values had become normal in 4/14 HBV-DNA-positive patients (28%), but all ''responders'' (4/4) relapsed. IgM anti-HBc was detected both before treatment and during ALT elevation in three patients and only during ALT relapse in another three. In the remaining 111 patients, a biochemical response to IFN treatment was observed in 54% and relapse of ALT values in 47%. ''Inapparent'' HBV/HCV coinfection may be implicated in cases of resistance to IFN. HBV replication and HBV-related liver damage may persist in patients in whom HCV replication was inhibited by current doses of IFN, as suggested also by the presence of IgM anti-HBc in some cases. Further studies will show the effect of different treatment schedules. HBV-DNA and/or IgM anti-HBc detection with very sensitive methods may be important both as a prognostic factor and as a tool for better understanding of intervirus relationships and mechanisms involved in multiple hepatitis virus infections.