Saitta Carlo, Pontisso Patrizia, Brunetto Maurizia R, Fargion Silvia, Gaeta Giovanni B, Niro Grazia A, Picciotto Antonio, Smedile Antonina, Squadrito Giovanni, Raimondo Giovanni
Unit of Clinical and Molecular Hepatology, Department of Internal Medicine, University of Messina, Italy.
Antivir Ther. 2006;11(7):931-4.
Hepatitis C virus (HCV) is believed to exert a suppressive effect on hepatitis B virus (HBV) in most HBV/HCV-coinfected patients; once HCV is cured by interferon-based therapy, these patients may show HBV reactivation. However, recent evidence revealed that the virological status in HBV/HCV-untreated individuals may vary over time and may show fluctuating profiles.
To evaluate the behaviour of apparently inactive HBV infection in patients under treatment for a concurrent HCV infection, we performed a prospective study that evaluated nine consecutive patients (eight males with a median age of 45.9 years, and one female aged 62 years) longitudinally followed-up with bi-monthly evaluation of HBV/HCV viraemia levels and liver biochemistry during a 1-year treatment with interferon plus ribavirin.
In seven cases the HBV infection maintained its inactive status independently of the HCV response to therapy. By contrast, two non-responder cases with persistently high HCV RNA levels showed HBV DNA flairs during the follow-up, indicating a status of active HBV infection with fluctuating virological profiles.
This study suggests that the HBV behaviour may be independent of the HCV activity during anti-HCV therapy in HBV/HCV-coinfected patients, and that the HBV virological profile should be monitored to recognize possible reactivations that might lead to more proper therapeutic choices or adjustments.
在大多数乙肝病毒（HBV）/丙肝病毒（HCV）合并感染患者中，丙肝病毒被认为对乙肝病毒有抑制作用；一旦丙肝通过基于干扰素的治疗得以治愈，这些患者可能会出现乙肝病毒再激活。然而，最近的证据显示，未经治疗的HBV/HCV感染者的病毒学状态可能随时间变化，且可能呈现波动状态。
为评估正在接受丙肝感染治疗的患者中表面上不活跃的乙肝感染的情况，我们进行了一项前瞻性研究，该研究对9例连续患者（8例男性，中位年龄45.9岁，1例62岁女性）进行了纵向随访，在使用干扰素加利巴韦林进行1年治疗期间，每两个月评估一次HBV/HCV病毒血症水平和肝脏生化指标。
7例患者中，乙肝感染保持不活跃状态，与丙肝对治疗的反应无关。相比之下，2例丙肝病毒核糖核酸（HCV RNA）水平持续较高的无反应患者在随访期间出现乙肝病毒脱氧核糖核酸（HBV DNA）波动，表明存在病毒学状态波动的活跃乙肝感染。
本研究表明，在HBV/HCV合并感染患者的抗丙肝治疗期间，乙肝的表现可能与丙肝活性无关，并且应该监测乙肝病毒学状态，以识别可能导致更恰当治疗选择或调整的再激活情况。
