Virological significance of low-level hepatitis B virus infection in patients with hepatitis C virus associated liver disease

✍ Scribed by Takeshi Tanaka; Kazuaki Inoue; Yukiko Hayashi; Aki Abe; Kyoko Tsukiyama-Kohara; Hideko Nuriya; Yoshikazu Aoki; Ryuji Kawaguchi; Kiichi Kubota; Makoto Yoshiba; Morio Koike; Satoshi Tanaka; Michinori Kohara

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 95 KB
• Volume: 72
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.10566

✦ Synopsis

Abstract

The clinical and virological significance of low‐level viremia by hepatitis B virus (HBV) in hepatitis C virus (HCV)‐infected patients remains unclear. HBV‐DNA and HCV‐RNA were, therefore, quantitatively analyzed in livers and sera from co‐infected patients. HBV‐DNA and HCV‐RNA were quantitated using real‐time detection of polymerase chain reaction (RTD‐PCR), based on Taq‐Man chemistry, in 220 non‐HCV‐infected healthy volunteers and 93 HCV‐infected patients without detectable HBsAg. Serum HBV‐DNA was detected in 4 (1.8%) of 220 non‐HCV‐infected healthy volunteers and 32 (34.4%) of 93 HCV‐infected patients without detectable HBsAg. HCV‐infected patients displayed higher frequency of HBV infection than healthy volunteers (P < 0.0001). Hepatocellular carcinoma (HCC) was more frequent among co‐infected patients than among HCV mono‐infected patients (P < 0.001). However, quantities of HBV‐DNA in sera from co‐infected patients were very low (8–19,000 copies/ml). HBV‐DNA was detected in liver tissue from co‐infected patients at 2–20 copies per 100 hepatocytes, accounting for 1/1,000 to 1/10,000 of HBsAg positive patients. In livers of patients with HCC and HCV or HBV mono‐infection, the viruses existed predominantly in non‐cancerous tissue, with levels 10‐ to 1,000‐fold and 1‐ to 100‐fold higher than in cancerous tissue, respectively. In contrast, patients co‐infected with HCV and HBV displayed decreased HBV levels in non‐cancerous tissue, but no change in cancerous tissue. These results indicate that low‐level HBV infection exists in HCV‐infected patients. HCC was more common among HCV/HBV co‐infected patients than among HCV mono‐infected patients. HCV might initiate hepatocarcinogenesis, but does not necessarily determine progression to HCC. J. Med. Virol. 72:223–229, 2004. © 2004 Wiley‐Liss, Inc.