Chakravarti Anita, Verma Vikas, Jain Manisha, Kar P
Department of Microbiology, Maulana Azad Medical College & Associated Lok Nayak Hospitals, New Delhi.
Trop Gastroenterol. 2005 Oct-Dec;26(4):183-7.
The major causes of chronic liver disease (CLD) are infection with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) either alone or together. The clinical course of the disease varies in cases ofcoinfection with HCV and HBV as compared to single infection. The present study was carried out to determine the occurrence of coinfection of HCV with HBV in CLD patients and to look for the presence of suppressive effect of the two viruses on each other. The severity of liver disease was also assessed and correlated with biochemical profiles. Sera from 150 patients of CLD were tested serologically for the presence of HBsAg, IgG anti HBc and anti-HCV antibodies. HBV DNA and HCV RNA were also detected by amplifying surface region and 5' noncoding-core region respectively by polymerase chain reaction. Forty-seven (31.3%) cases showed the presence of HBsAg or anti IgG-HBc or HBV DNA either alone or together (Group A). Thirty-nine (26%) cases were found to be positive for HCV by detecting either anti-HCV antibodies or HCV RNA (Group B). Coinfection ofHCV with HBV (Group C) could be detected in twenty-four (16%) cases, of these twenty-one cases (87.5%) were positive both for HCV RNA and IgG anti-HBc without the presence of HBV DNA whereas in none of the cases could HBV DNA be detected in the absence of HCV RNA. Forty (26.6%) cases had neither HCV or HBV related CLD. Amongst, the biochemical parameters, the liver function test profiles were altered and found to be statistically significantly in HCV positive cases (Group B) when compared to the negative ones while in case of HBV (Group A) and coinfected (Group C) cases none of the parameters was statistically significant when compared with non-HBV and non-coinfected cases respectively. Thus, coinfection of HCV with HBV is seen in a substantial number of CLD cases. It is also revealed from the present study that HCV infection has a suppressive effect on the replication of HBV as seen by the loss of replicative markers like HBV DNA.
慢性肝病（CLD）的主要病因是单独或同时感染乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）。与单一感染相比，HCV和HBV合并感染时疾病的临床病程有所不同。本研究旨在确定CLD患者中HCV与HBV合并感染的发生率，并寻找两种病毒之间的相互抑制作用。同时还评估了肝病的严重程度，并将其与生化指标相关联。对150例CLD患者的血清进行了HBsAg、IgG抗HBc和抗HCV抗体的血清学检测。还分别通过聚合酶链反应扩增表面区域和5'非编码核心区域来检测HBV DNA和HCV RNA。47例（31.3%）病例单独或同时出现HBsAg或抗IgG-HBc或HBV DNA（A组）。通过检测抗HCV抗体或HCV RNA发现39例（26%）病例HCV呈阳性（B组）。在24例（16%）病例中检测到HCV与HBV合并感染（C组），其中21例（87.5%）HCV RNA和IgG抗HBc均为阳性，但未检测到HBV DNA，而在没有HCV RNA的情况下均未检测到HBV DNA。40例（26.6%）病例既没有与HCV或HBV相关的CLD。在生化参数中，与阴性病例相比，HCV阳性病例（B组）的肝功能测试指标发生改变且具有统计学意义，而对于HBV（A组）和合并感染（C组）病例，与非HBV和非合并感染病例相比，各参数均无统计学意义。因此，在大量CLD病例中可见HCV与HBV合并感染。本研究还表明，如HBV DNA等复制标志物的缺失所示，HCV感染对HBV复制具有抑制作用。
