Hepatitis B virus and hepatitis C virus dual infection among patients with chronic liver disease
Shanmugam Saravanan1,2, Vijayakumar Velu1, Subhadra Nandakumar1, Vidya Madhavan2, Uma Shanmugasundaram2, Kailapuri G. Murugavel2, Pachamuthu Balakrishnan2, Nagalingeswaran Kumarasamy2, Suniti Solomon2, Sadras Panchatcharam Thyagarajan1,2
1Department of Microbiology, Faculty of Medicine, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras; and 2YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, India
Received: June 18, 2007 Revised: March 21, 2008 Accepted: April 28, 2008
Background and purpose:
Hepatitis B virus (HBV) and hepatitis C virus (HCV) dual infection accounts for a substantial proportion of liver diseases worldwide. Although the exact prevalence is not known, these viral infections are common among patients with chronic liver disease (CLD). This study was performed to determine the prevalence of HBV and HCV dual infection among patients with CLD in Chennai, India.
251 patients were tested for the presence of hepatitis B surface antigen (HBsAg), immunoglobulin (Ig)-M/IgG antibody to hepatitis B core antigen (anti-HBc) and anti-HCV antibodies, and HBV-DNA and HCVRNA by qualitative polymerase chain reaction.
Coinfection with HCV and HBV was detected in 15 patients (5.9%), 12 of whom (80.0%) were positive for HCV-RNA and IgG anti-HBc with no evidence of HBV-DNA, while 3 HBsAg-negative patients (20.0%) were positive for HBV-DNA in addition to HCV-RNA. Liver function test profiles were significantly altered for HCVpositive patients compared with HBV-positive and HBV/HCV coinfected patients (p = 0.001). Bilirubin and alanine aminotransferase levels were significantly raised in coinfected patients compared with non-HBV, non-HCV patients (p = 0.001).
The results demonstrated that HBV was predominantly associated with underlying CLD among this group of patients in India and suggest that HBV coinfection in HCV-infected patients should not be excluded by negative HBsAg status alone.
Hepacivirus; Hepatitis B virus; India; Infection; Liver diseases
J Microbiol Immunol Infect. 2009;42:122-128.