Coinfection of hepatitis C virus in patients with chronic hepatitis B infection

J Hepatol. 1994 Aug;21(2):159-66. doi: 10.1016/s0168-8278(05)80389-7.


Enzyme-linked immunosorbent assays for detecting antibodies against hepatitis C virus and the polymerase chain reaction were tested in 82 chronic hepatitis B surface antigen carriers for their accuracy in diagnosing patients coinfected with hepatitis B and C viruses. To clarify the role of each virus in chronic hepatitis, serologic assays against hepatitis B virus were also tested. Thirteen (14.9%), 14 (17.1%) and 15 (18.3%) patients were anti-HCV positive using C100 (HCV1), JCC, and a second generation test (HCV2), respectively. HCV RNA was detected by polymerase chain reaction in 9 of 18 anti-HCV-positive cases. Although HCV1 assays were not sufficient, either the JCC or HCV2 assay detected all polymerase chain reaction-positive cases. Fifteen of 18 specimens that were positive in at least one of the three ELISA were seronegative for the hepatitis B e antigen. As judged by HBV DNA polymerase activity, titers of hepatitis B surface antigen and immunoglobulin A antibody against hepatitis B core antigen (IgA anti-HBc), activity of hepatitis B virus replication and immune response against hepatitis B virus in patients with coinfection was decreased to the level of hepatitis B virus asymptomatic carriers. These results show that hepatitis C virus appears to be the primary cause of active hepatitis in most patients with hepatitis B and hepatitis C virus coinfection.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Disease
  • DNA, Viral / analysis
  • DNA, Viral / genetics
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hepacivirus / genetics
  • Hepacivirus / immunology
  • Hepatitis Antibodies / analysis
  • Hepatitis B / complications*
  • Hepatitis B / diagnosis
  • Hepatitis B / immunology
  • Hepatitis B Antibodies / analysis
  • Hepatitis B Core Antigens / analysis
  • Hepatitis B Surface Antigens / analysis
  • Hepatitis B virus / genetics
  • Hepatitis B virus / immunology
  • Hepatitis C / complications*
  • Hepatitis C / diagnosis
  • Hepatitis C / immunology
  • Hepatitis C Antibodies
  • Humans
  • Immunoglobulin A / analysis
  • Immunoglobulin A / immunology
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • RNA, Viral / analysis
  • RNA, Viral / genetics


  • DNA, Viral
  • Hepatitis Antibodies
  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Hepatitis B Surface Antigens
  • Hepatitis C Antibodies
  • Immunoglobulin A
  • RNA, Viral