Department of Internal Medicine and Hepatology, Second University of Naples, Naples, Italy.
J Med Virol. 2009 Dec;81(12):2012-20. doi: 10.1002/jmv.21560.
Co-infection with HBV and HCV seems to be associated with more severe liver disease in retrospective and cross-sectional studies in adults, but no data are available when co-infection is acquired in youth. The long-term outcome of infection acquired in youth was assessed in patients co-infected with HBV and HCV and in patients with HBV infection only. Twenty-seven patients with HBV and HCV co-infection and 27 patients infected with HBV only were enrolled. Seventy-six per cent of the patients were treated with alpha-interferon for 1 year. After a median follow-up of 23 years, the annual progression rate of fibrosis was 0.07 in patients co-infected with HBV and HCV, and in those infected with HBV it was 0.07 and 0.11 (P < 0.004) for HBe and anti-HBe-positive patients, respectively. In co-infected patients, the development of cirrhosis was observed in 2 (7.4%) and of hepatocellular carcinoma (HCC) in 1 (3.7%), while in those with HBV, cirrhosis appeared in one patient (3.7%). Alcohol intake (OR = 9.5 +/- 1.2; 95% CI = 6.6-13.9; P < 0.0001) was independently associated with cirrhosis and HCC. alpha-interferon showed no efficacy during treatment, but the treated group showed higher HCV RNA clearance during post-treatment follow-up. Co-infection with HBV and HCV and single HBV infection acquired in youth showed a low rate of progression to liver fibrosis, no liver failure, and low development of HCC during a median follow-up of 23 years (range 17-40).
乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）合并感染似乎与成人回顾性和横断面研究中更严重的肝脏疾病相关，但在青少年获得合并感染时，尚无相关数据。本研究旨在评估青少年获得的 HBV 和 HCV 合并感染的长期结局。研究纳入了 27 例 HBV 和 HCV 合并感染患者和 27 例单纯 HBV 感染患者。76%的患者接受了为期 1 年的α干扰素治疗。中位随访 23 年后，HBV 和 HCV 合并感染患者的纤维化年度进展率为 0.07，HBeAg 阳性和 HBeAg 阴性患者的纤维化年度进展率分别为 0.07 和 0.11（P<0.004）。在合并感染患者中，2 例（7.4%）发展为肝硬化，1 例（3.7%）发展为肝细胞癌（HCC），而在单纯 HBV 感染患者中，1 例（3.7%）发展为肝硬化。饮酒（OR=9.5 +/- 1.2；95%CI=6.6-13.9；P<0.0001）与肝硬化和 HCC 独立相关。α干扰素治疗期间无疗效，但治疗组在治疗后随访期间 HCV RNA 清除率较高。在中位随访 23 年（范围 17-40 年）期间，青少年获得的 HBV 和 HCV 合并感染及单纯 HBV 感染后，肝脏纤维化进展、肝功能衰竭和 HCC 发生率均较低。
