HCV genotype and "silent' HBV confections : two main isk factors for a more severe liver disease

الملخص EN

Aim : to evaluate whether HCV ecotype and "silent" HBV infection may be related to a more severe clinical presentation of liver disease.

Patients & Methods : 40 anti-HCV / HCV-RNA positive, HBsAg / anti-HBs negative patients with chronic hepatitis (27 males and 13 females, median ae 43+6.98) years, were studied on presentation at National Liver Institute, Menifee University.

Presence of serum anti-HBc, in absence of HBsAg and anti-HBs, was considered a marker of "silent" HBV infection.

Two main diagnosis groups were established: the mild liver disease group (Gl n = 20), and the severe liver disease group (G2 n = 20).

Results : the prevalence of silent HBV infection in HCV patients was 50 % where out of the 40 anti-HCV / HCV-RNA positive, HBsAg and anti-HBs negative patients with a definite diagnosis, 20 patients (50 %) were anti-HBc positive.

Of the 20 anti-HBc positive patients, HBeAg /anti-HBc system was investigated, where 14 patients (70 %) were anti-HBe positive and 6 patients (30 %) were anti-HBe negative.

None of these 20 patients was HBeA positive.

Twelve (60 %) out of the 20 HBcAb + ve cases were found to be positive for serum HBV-DNA by PCR.

In the present study, it was found that the prevalence of a severe liver disease was higher in anti-HBc positive cirrhotic HCV patients lackin both HBsAg and anti-HBs (silent HBV infection) than in cirrhotic HCV patients with no markers of HBV infection (80 % vs.

20 %, P < 0.001), indicating that a "silent HBV infection" may unfavorably influence the course of the disease.

This was observed both in HBV-DNA positive and in HBV-DNA negative patients and regardless HCV genotype.

Conclusion : Silent HBV infection seems to be a major risk factor for an unfavorable course of the disease.

The observation that anti-HBc positive / HBV-DNA negative patients show a similar prevalence of severe liver disease to anti-HBc / HBV-DNA positive patients and a significantly higher prevalence than anti-HBc negative cases supports further the view that isolated serum anti-HBc is a marker of clinical significance.