Pontisso P, Gerotto M, Benvegnù L, Chemello L, Alberti A
Department of Clinical and Experimental Medicine, University of Padova, Italy.
Antivir Ther. 1998;3(Suppl 3):137-42.
Coinfection by hepatotropic viruses can occur due to the fact that hepatitis B virus (HBV) and hepatitis C virus (HCV) share similar routes of transmission. Different clinical features of liver disease can be observed in infected patients, ranging from fulminant, acute and chronic hepatitis to hepatocellular carcinoma (HCC). The relative role of the infecting viruses in determining the final clinical picture is not yet well defined. Several reports indicate that clinical and pathological severity of liver disease among coinfected patients is increased and in patients with HCC, co-occurrence of both viruses is a common event. The potential mechanism of tumour development still remains speculative, although direct and indirect roles for both HBV and HCV have been proposed. At the molecular level, reciprocal interference of virus replication has been repeatedly described and the extent of interference is influenced by the infecting HCV genotype, genotype 1 of HCV having more efficient inhibitory activity on HBV than genotype 2. Sequence similarities between an arginine-rich nucleocapsid motif of both viruses could support these clinical observations. Concerning response rates to interferon therapy, no satisfactory results have been achieved to date, although identification of effective therapeutic schemes, based on virological status of both viruses are warranted.
嗜肝病毒的合并感染可能会发生，因为乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）具有相似的传播途径。在受感染的患者中可以观察到不同的肝病临床特征，从暴发性、急性和慢性肝炎到肝细胞癌（HCC）。感染病毒在决定最终临床症状方面的相对作用尚未明确界定。一些报告表明，合并感染患者中肝病的临床和病理严重程度会增加，在肝细胞癌患者中，两种病毒同时出现是常见现象。尽管已经提出了HBV和HCV的直接和间接作用，但肿瘤发生的潜在机制仍然是推测性的。在分子水平上，病毒复制的相互干扰已被反复描述，干扰程度受感染的HCV基因型影响，HCV 1型对HBV的抑制活性比2型更有效。两种病毒富含精氨酸的核衣壳基序之间的序列相似性可以支持这些临床观察结果。关于干扰素治疗的应答率，尽管有必要根据两种病毒的病毒学状态确定有效的治疗方案，但迄今为止尚未取得令人满意的结果。
