[Features of combined (HBV/HCV-infection) viral lesion of the liver].

AIM

To study clinical, biochemical features, course of combined viral hepatitides, dominant viral activity in combination HBV/HCV infection.

MATERIAL AND METHODS

A total of 37 patients with HbsAg and anti-HCV, 23 patients with chronic hepatitis C and 48 patients with chronic hepatitis B were examined (the study and comparison groups, respectively). 67 HbsAg carriers with normal,hepatic parameters (no clinical symptoms, normal transaminase activity) served controls.

RESULTS

In patients with parallel detection of HbsAg and anti-HCV detectability of HBV-DNA was 8.1% while HCVrNA was detected in 84% cases. Half the patients with HbeAg positive HBV had seroconversion 1.5-2 years after HCV infection. Documented HCV infection in HBV patients leads to elimination of one of the viruses (HBV more frequently) in more than 50% cases. HCV infection may induce seroconversion of HbeAg. Biochemical parameters (bilirubin, AIAT, AP, gamma HTP of blood) in patients with mixed infection compared with those with mono-infection were 1.5 times higher. In mixed infection cytokines (TNF-alpha, IL-1 beta, IL-6, IL-8, TGF-lbeta) levels were also higher, the diameter of the portal vein was larger (16.9 +/- 0.5 mm). Conclusion. In mixed viral infection there are marked changes in clinico-biochemical, morphological and hemodynamic indices with a clear trend to early formation of portal hypertension with significant alterations in the esophago-gastroduodenal zone.