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Clinicopathologic features of dual chronic hepatitis B and C infection: A comparison with single hepatitis B, C and delta infections

Hakan Senturk, Veysel Tahan, Billur Canbakan, Faysal Dane, Yakup Ulger, Resat Ozaras, Fehmi Tabak, Ali Mert, Gulsen Ozbay

Abstract

There is controversial data in the literature about the characteristics or features of dual hepatitis B and C infection. Several studies have reported that the dual infection has a more severe histological picture; faster progression leading to cirrhosis and a higher risk for hepatocellular carcinoma compared with the single infections. These findings have not yet been supported. We assessed the patients with dual hepatitis B and C infection with respect to their different features in our country. Method: the chronic hepatitis patients of our clinics were tested, and both HBsAg and anti-HCV positive patients with chronic hepatitis were enrolled to the study. All patients were tested for the biochemical parameters and the presence of HBV-DNA and HCVRNA. Results: Of the 1950 patients, 51 (2.6%) were both HBsAg and anti-HCV positive and 67 were antidelta positive. Patients were followed up for 5.4 ± 2.1 years. Of the 51 dual hepatitis patients, 6 had no HBVDNA and HCV-RNA detectable by PCR, 36 were only HCV-RNA positive, 9 were only HBV-DNA positive and 3 were both HBV-DNA and HCV-RNA positive. Dominant infection in ¾ of the patients was hepatitis C. Clinical and histological properties of the cases with dual Hepatitis B and C infection showed no significant differences compared to the single infections. In conclusion, regarding the prognosis, no significant differences were found between such dual and single infections. Dual infection with hepatitis B virus and delta virus is a significantly more severe condition than the dual infection with hepatitis B and C viruses.

Key words. Chronic Hepatitis B and C, hepatitis delta virus, liver cirrhosis, hepatocellular carcinoma

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The Official Journal of the Mexican Association of Hepatology, the Latin-American Association for the Study of the Liver and the Canadian Association for the Study of the Liver

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