[Clinical and virological course of dual infection by hepatitis B and C viruses in China].

OBJECTIVE

To investigate the clinical and virological course of dual infection by hepatitis B virus (HBV) and hepatitis C virus (HCV) in China.

METHODS

We enrolled 40 patients with chronic HBV and HCV dual infection (Group BC), 16 patients with chronic single HBV infection (Group B) and 31 patients with chronic single HCV infection (Group C). They infected HBV and/or HCV during 1982 to 1989. The sera of all the 87 patients were collected in 1994 and 2002 respectively. We detected biochemical and virologic markers and quantitative serum HCV DNA and HCV RNA levels of all the patients. The B-type ultrasound detecting was performed in some patients.

RESULTS

In Group BC, 67.5% of the patients have cleared HBsAg, and 92.5% of the patients have cleared HBeAg. The clearance rate of HBV DNA was 87.5%. There was no significant difference of HBV clearance between Group BC and Group B. In Group BC, the clearance rate of HBV-RNA was 87.5%, significantly higher than those in Group C. Less than 40% of the patients in all groups have elevated liver enzyme values. The highest value of alanine aminotransferase (ALT) was 218 u/L (normal range for ALT 0 - 40 u/L). In most patients the ultrasonogram presentations were changed mildly.

CONCLUSION

The clinical presentation of patients with HBV/HCV coinfection seemed mild and occult. High clearance of HBV, easy to clear HBV in male patient was the characteristics of infection by HBV in adult time in China. HBV could inhibit HCV replication, but no evidence could be found in our data that HCV could suppress HBV replication.