Zarski J P, Bohn B, Bastie A, Pawlotsky J M, Baud M, Bost-Bezeaux F, Tran van Nhieu J, Seigneurin J M, Buffet C, Dhumeaux D
Département d'Hépato-Gastroentérologie, C.H.U. de Grenoble - BP 217, France.
J Hepatol. 1998 Jan;28(1):27-33. doi: 10.1016/s0168-8278(98)80198-0.
BACKGROUND/AIMS: The purpose of this study was to compare the epidemiological, biochemical, virological and histological characteristics of patients with chronic hepatitis B and C with those of patients suffering from chronic hepatitis C alone.
Twenty-three patients with chronic hepatitis C, who were anti-HCV positive and HBs antigen positive, were studied and subdivided into two groups according to the presence or absence of HBV DNA replication. They were compared to 69 age- and sex-matched patients with chronic hepatitis who were anti-HCV positive and HBs antigen negative. All patients were HCV RNA positive by PCR, anti-HIV negative and anti-HDV negative. HBV DNA and HCV RNA were detected in serum by means of a branched DNA assay and PCR. The HCV serotypes were determined by the Chiron Riba HCV serotyping SIA technique. The histological characteristics included the Knodell score.
Epidemiological, biochemical and virological parameters were not different between the two groups. Only the prevalence of cirrhosis was greater in chronic hepatitis B and C patients than in patients with chronic hepatitis C alone (p = 0.01). Among chronic hepatitis B and C patients, HCV RNA level was significantly lower in HBV DNA positive than in HBV DNA negative patients (p = 0.01). Indeed, histological lesions were more severe in HBV DNA positive than in HBV DNA negative patients, including prevalence of cirrhosis (p = 0.01), Knodell score (p = 0.05) and, among the latter, piecemeal necrosis (p = 0.01) and fibrosis (p = 0.05). The characteristics of patients with dual infection did not differ according to the mode of contamination and duration of HBV disease, except for a shorter duration in patients contaminated by drug abuse than in other patients.
These results suggest that HBV DNA replication inhibits HCV RNA replication in patients with chronic active hepatitis B and C but increases the severity of histological lesions.
背景/目的：本研究旨在比较慢性乙型和丙型肝炎患者与单纯慢性丙型肝炎患者的流行病学、生化、病毒学及组织学特征。
对23例抗-HCV阳性且HBs抗原阳性的慢性丙型肝炎患者进行研究，并根据是否存在HBV DNA复制将其分为两组。将他们与69例年龄和性别匹配的抗-HCV阳性且HBs抗原阴性的慢性肝炎患者进行比较。所有患者PCR检测HCV RNA均为阳性，抗-HIV和抗-HDV均为阴性。采用分支DNA分析法和PCR检测血清中的HBV DNA和HCV RNA。通过Chiron Riba HCV血清学分型SIA技术确定HCV血清型。组织学特征包括Knodell评分。
两组患者的流行病学、生化和病毒学参数无差异。仅慢性乙型和丙型肝炎患者的肝硬化患病率高于单纯慢性丙型肝炎患者（p = 0.01）。在慢性乙型和丙型肝炎患者中，HBV DNA阳性患者的HCV RNA水平显著低于HBV DNA阴性患者（p = 0.01）。事实上，HBV DNA阳性患者的组织学病变比HBV DNA阴性患者更严重，包括肝硬化患病率（p = 0.01）、Knodell评分（p = 0.05），以及在后者中的桥接坏死（p = 0.01）和纤维化（p = 0.05）。除了药物滥用感染患者的病程比其他患者短外，双重感染患者的特征在感染方式和HBV疾病持续时间方面无差异。
这些结果表明，在慢性乙型和丙型活动性肝炎患者中，HBV DNA复制抑制HCV RNA复制，但增加了组织学病变的严重程度。
