Prevalence of Occult Hepatitis B Among HCV Patients Resistance to Antiviral Therapy
Sameh Mohamed Shalaby;
Abstract
Hepatitis B virus is one of the most infectious diseases worldwide. HBV is transmitted through blood, semen, vaginal fluid, serous fluid and saliva and it is a major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma.
Occult hepatitis B infection is characterized by presence of HBV-DNA inspite of absence of HBsAg.
The prevalence of occult HBV is affected by endemicity of HBV, the population of study as it is more common among patients with chronic liver disease than in healthy individuals and severity of liver disease as it is more common among patients with liver cirrhosis or HCC than in patients with chronic hepatitis.
Occult HBV infection harbors potential risk of HBV transmission through blood transfusion, hemodialysis and organ transplantation. It may serve as a cause of cryptogenic liver cirrhosis, fulminant hepatitis, and acute exacerbation of chronic hepatitis B and development of HCC.
Both HBV and HCV share common routes of transmission and hence there is a fairly general agreement in considering HCV infected patients as the category of individuals with the highest prevalence of occult HBV. In particular, HBV DNA is detectable in about one-third of HBsAg negative HCV carriers in the Mediterranean basin, and this prevalence is even higher in Far East Asian countries.
Occult HBV in chronic hepatitis C patients may be associated with more severe liver disease, poor response to treatment and increased risk of HCC development.
The aim of our study is to determine the prevalence of occult HBV among HCV patients resistance to antiviral therapy in Egypt.
This study had included 100 HCV infected patients resistance to antiviral therapy. All patients were negative for HBsAg.
Patients were divided into two groups according to their HBV-DNA status:
Group 1: 19 patients (14 male&5 female) positive for HBV-DNA (occult HBV/HCV dual infection)
Group 2: 81 patients(71 male&10female) patients negative for HBV-DNA (HCV mono-infection).
All the patients subjected to:
1- Thorough history taking.
2- Complete physical examination with particular emphasis on signs of chronic liver disease.
3- Laboratory investigations including:
• Complete blood count.
• Blood urea and serum creatinine.
o Liver function test:
o AST and ALT.
o Serum bilirubin (total and direct).
o Serum albumin.
o Prothrombin concentration.
4- Imaging techniques:
• Abdominal ultrasound.
5- Viral markers:
• HBsAg, HBsAb, HBcAb.
6- Specific investigations:
• PCR for HBV-DNA.
Results showed that:
1- No significant difference regarding sex between both groups.G1(14male&5female)&G2 (71male&10female).
2- Mean value of age is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(48.32±9.01)years& G2(41.77±10.49)years.
3- Mean value of body mass index is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(25.56±1.24) & G2(23.65±3.12).
4- Mean value of total cholesterol is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(183.26±16.03)mg/dl & G2(147.50±33.04)mg/dl.
5- No significant difference between both groups regarding total triglycerides. G1(113.07±28.69)mg/dl & G2(100.44±38.87)mg/dl.
6- Mean value of liver enzymes (AST and ALT) is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. *ALT G1(70.16±19.18)u/l & G2(33.35±25.29)u/l * AST G1(82.32±37.48)u/l & G2(34.79±15.29)u/l.
7- Mean value of INR is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(1.57±0.34) & G2(1.15±0.19).
8- No significant difference between both groups regarding total bilirubin, direct bilirubin and serum albumin.
*T.Bil G1(0.98±0.24)mg/dl & G2(0.90±0.38)mg/dl.
*D.Bil G1(0.51±0.18)mg/dl & G2(0.42±0.23)mg/dl
*S.Alb G1(4.15±0.37)g/dl & G2(4.09±0.58)g/dl
9- No significant difference between both groups regarding kidney functions, WBCs and HB.
*Urea G1(35.05±22.76)mg/dl & G2(31.58±23.89)mg/dl
*Creat. G1(0.79±0.09)mg/dl &G2(0.76±0.09)mg/dl
*WBCs G1(5.66±2.74) &G2(5.01±1.89)
*HB G1(11.97±2.32)g/dl &G2(12.39±1.99)g/dl
10- Mean value of platelets is significantly lower among occult HBV/HCV dual infection than HCV monoinfection.
G1(110.84±33.11) & G2(185.64±55.24)
11- Mean value of spleen size and portal vein diameter is significantly higher among occult HBV/HCV dual infection than HCV monoinfection.
*Spleen size G1(13.72±0.92)cm &G2(11.69±1.93)cm
*P.V diameter G1(13.27±0.46)mm &G2(12.08±0.98)mm
12- HBV-DNA was positive in 19 out of 100 (19%) and none of these 19 patients was positive for HBsAg, HBsAb or HBcAb.
Occult hepatitis B infection is characterized by presence of HBV-DNA inspite of absence of HBsAg.
The prevalence of occult HBV is affected by endemicity of HBV, the population of study as it is more common among patients with chronic liver disease than in healthy individuals and severity of liver disease as it is more common among patients with liver cirrhosis or HCC than in patients with chronic hepatitis.
Occult HBV infection harbors potential risk of HBV transmission through blood transfusion, hemodialysis and organ transplantation. It may serve as a cause of cryptogenic liver cirrhosis, fulminant hepatitis, and acute exacerbation of chronic hepatitis B and development of HCC.
Both HBV and HCV share common routes of transmission and hence there is a fairly general agreement in considering HCV infected patients as the category of individuals with the highest prevalence of occult HBV. In particular, HBV DNA is detectable in about one-third of HBsAg negative HCV carriers in the Mediterranean basin, and this prevalence is even higher in Far East Asian countries.
Occult HBV in chronic hepatitis C patients may be associated with more severe liver disease, poor response to treatment and increased risk of HCC development.
The aim of our study is to determine the prevalence of occult HBV among HCV patients resistance to antiviral therapy in Egypt.
This study had included 100 HCV infected patients resistance to antiviral therapy. All patients were negative for HBsAg.
Patients were divided into two groups according to their HBV-DNA status:
Group 1: 19 patients (14 male&5 female) positive for HBV-DNA (occult HBV/HCV dual infection)
Group 2: 81 patients(71 male&10female) patients negative for HBV-DNA (HCV mono-infection).
All the patients subjected to:
1- Thorough history taking.
2- Complete physical examination with particular emphasis on signs of chronic liver disease.
3- Laboratory investigations including:
• Complete blood count.
• Blood urea and serum creatinine.
o Liver function test:
o AST and ALT.
o Serum bilirubin (total and direct).
o Serum albumin.
o Prothrombin concentration.
4- Imaging techniques:
• Abdominal ultrasound.
5- Viral markers:
• HBsAg, HBsAb, HBcAb.
6- Specific investigations:
• PCR for HBV-DNA.
Results showed that:
1- No significant difference regarding sex between both groups.G1(14male&5female)&G2 (71male&10female).
2- Mean value of age is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(48.32±9.01)years& G2(41.77±10.49)years.
3- Mean value of body mass index is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(25.56±1.24) & G2(23.65±3.12).
4- Mean value of total cholesterol is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(183.26±16.03)mg/dl & G2(147.50±33.04)mg/dl.
5- No significant difference between both groups regarding total triglycerides. G1(113.07±28.69)mg/dl & G2(100.44±38.87)mg/dl.
6- Mean value of liver enzymes (AST and ALT) is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. *ALT G1(70.16±19.18)u/l & G2(33.35±25.29)u/l * AST G1(82.32±37.48)u/l & G2(34.79±15.29)u/l.
7- Mean value of INR is significantly higher among occult HBV/HCV dual infection than HCV monoinfection. G1(1.57±0.34) & G2(1.15±0.19).
8- No significant difference between both groups regarding total bilirubin, direct bilirubin and serum albumin.
*T.Bil G1(0.98±0.24)mg/dl & G2(0.90±0.38)mg/dl.
*D.Bil G1(0.51±0.18)mg/dl & G2(0.42±0.23)mg/dl
*S.Alb G1(4.15±0.37)g/dl & G2(4.09±0.58)g/dl
9- No significant difference between both groups regarding kidney functions, WBCs and HB.
*Urea G1(35.05±22.76)mg/dl & G2(31.58±23.89)mg/dl
*Creat. G1(0.79±0.09)mg/dl &G2(0.76±0.09)mg/dl
*WBCs G1(5.66±2.74) &G2(5.01±1.89)
*HB G1(11.97±2.32)g/dl &G2(12.39±1.99)g/dl
10- Mean value of platelets is significantly lower among occult HBV/HCV dual infection than HCV monoinfection.
G1(110.84±33.11) & G2(185.64±55.24)
11- Mean value of spleen size and portal vein diameter is significantly higher among occult HBV/HCV dual infection than HCV monoinfection.
*Spleen size G1(13.72±0.92)cm &G2(11.69±1.93)cm
*P.V diameter G1(13.27±0.46)mm &G2(12.08±0.98)mm
12- HBV-DNA was positive in 19 out of 100 (19%) and none of these 19 patients was positive for HBsAg, HBsAb or HBcAb.
Other data
| Title | Prevalence of Occult Hepatitis B Among HCV Patients Resistance to Antiviral Therapy | Other Titles | دراسة مدى شيوع الالتهاب الكبدي الوبائي بى الخفي بين المرضي المصابين بالالتهاب الكبدي الوبائي سى المقاوم للعلاج المضاد للفيروسات | Authors | Sameh Mohamed Shalaby | Issue Date | 2014 |
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