Characteristics of patients with dual infection by hepatitis B and C viruses

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.

Methods: 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.

Results: 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.

Conclusions: 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.

MeSH terms

  • Adult
  • Biopsy, Needle
  • Blood Transfusion
  • DNA, Viral / analysis
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hepacivirus / isolation & purification
  • Hepatitis B / complications*
  • Hepatitis B / epidemiology
  • Hepatitis B / pathology
  • Hepatitis B / physiopathology
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B e Antigens / blood
  • Hepatitis B virus / isolation & purification
  • Hepatitis C / complications*
  • Hepatitis C / epidemiology
  • Hepatitis C / pathology
  • Hepatitis C / physiopathology
  • Humans
  • Liver / pathology
  • Liver Function Tests
  • Male
  • Polymerase Chain Reaction
  • RNA, Viral / analysis
  • Substance-Related Disorders


  • DNA, Viral
  • Hepatitis B Surface Antigens
  • Hepatitis B e Antigens
  • RNA, Viral