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Qian J, Yue M, Huang P, Ai L, Zhu C, Wang C, Luo Y, Yue N, Wu Y, Zhang Y, Wang C, Tan W. Spatiotemporal heterogeneity and impact factors of hepatitis B and C in China from 2010 to 2018: Bayesian space-time hierarchy model. Front Cell Infect Microbiol 2023; 13:1115087. [PMID: 36923590 PMCID: PMC10008934 DOI: 10.3389/fcimb.2023.1115087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/13/2023] [Indexed: 03/03/2023] Open
Abstract
Introduction Viral hepatitis is a global public health problem, and China still faces great challenges to achieve the WHO goal of eliminating hepatitis. Methods This study focused on hepatitis B and C, aiming to explore the long-term spatiotemporal heterogeneity of hepatitis B and C incidence in China from 2010 to 2018 and quantify the impact of socioeconomic factors on their risk through Bayesian spatiotemporal hierarchical model. Results The results showed that the risk of hepatitis B and C had significant spatial and temporal heterogeneity. The risk of hepatitis B showed a slow downward trend, and the high-risk provinces were mainly distributed in the southeast and northwest regions, while the risk of hepatitis C had a clear growth trend, and the high-risk provinces were mainly distributed in the northern region. In addition, for hepatitis B, illiteracy and hepatitis C prevalence were the main contributing factors, while GDP per capita, illiteracy rate and hepatitis B prevalence were the main contributing factors to hepatitis C. Disussion This study analyzed the spatial and temporal heterogeneity of hepatitis B and C and their contributing factors, which can serve as a basis for monitoring efforts. Meanwhile, the data provided by this study will contribute to the effective allocation of resources to eliminate viral hepatitis and the design of interventions at the provincial level.
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Affiliation(s)
- Jiaojiao Qian
- Department of Epidemiology, School of Public Health, Nanjing Medical University., Nanjing, China
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Ming Yue
- Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Peng Huang
- Department of Epidemiology, School of Public Health, Nanjing Medical University., Nanjing, China
| | - Lele Ai
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Changqiang Zhu
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Chongcai Wang
- Department of infectious diseases prevention, Hainan International Travel Healthcare Center, Haikou, China
| | - Yizhe Luo
- Department of Epidemiology, School of Public Health, Nanjing Medical University., Nanjing, China
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Na Yue
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Yifan Wu
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Yun Zhang
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Chunhui Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University., Nanjing, China
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
- *Correspondence: Chunhui Wang, ; Weilong Tan,
| | - Weilong Tan
- Department of Epidemiology, School of Public Health, Nanjing Medical University., Nanjing, China
- Department of infectious diseases prevention, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
- *Correspondence: Chunhui Wang, ; Weilong Tan,
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Jacob R, Danta M. Pharmacotherapeutic strategies for hepatitis B and hepatitis C coinfection. Expert Opin Pharmacother 2021; 23:465-472. [PMID: 34937470 DOI: 10.1080/14656566.2021.2019708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Hepatitis B (HBV) and Hepatitis C (HCV) infection place a significant burden on the global health system, with chronic carriage leading to cirrhosis and hepatocellular carcinoma. HBV/HCV coinfection can be seen in highly endemic areas and present a heterogenous group given varying virologic profiles. Coinfected patients have a greater risk of advanced liver disease; hence, diagnosis and early antiviral therapy (AVT) should be a priority. Optimal treatment regimens for coinfected patients remain unknown with differing recommendations, particularly relating to the risk of HBV reactivation whilst on AVT for HCV. AREAS COVERED This article summarizes the available data on HBV/HCV coinfection with regards to epidemiology, virologic interactions, and risk of HBV reactivation. The authors also provide a framework for the assessment and treatment of coinfected patients. EXPERT OPINION There is a moderate risk of HBV reactivation in hepatitis B surface antigen (HBsAg) positive patients undergoing HCV direct-acting antiviral (DAA) treatment; however, clinically significant events are rare. The risk of HBV reactivation in HBsAg negative patients undergoing HCV DAA treatment is negligible. Thus, prophylactic HBV treatment in both groups is not required. The authors recommend close monitoring with HBV treatment if there is evidence of HBV reactivation or elevated alanine aminotransferase levels.
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Affiliation(s)
- Rachael Jacob
- Department of Gastroenterology, St Vincent's Hospital, Sydney, Australia.,St Vincent's Clinical School, Faculty of Medicine, Unsw Sydney, St Vincent's Hospital, Sydney, Australia
| | - Mark Danta
- Department of Gastroenterology, St Vincent's Hospital, Sydney, Australia.,St Vincent's Clinical School, Faculty of Medicine, Unsw Sydney, St Vincent's Hospital, Sydney, Australia
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Prevalence of Hepatitis C Virus Infection in a Surgical Population of Southeast China: A Large-Scale Multicenter Study. Can J Gastroenterol Hepatol 2020; 2020:8219536. [PMID: 32377514 PMCID: PMC7180502 DOI: 10.1155/2020/8219536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic HCV infection affects 80 million people globally and may progress to advanced liver disease. The present study aims to investigate the present epidemiology of HCV infection in a southeastern Chinese surgical patient cohort. METHODS Blood samples obtained from 78,484 surgical patients from 18 different city and county hospitals were enrolled. The incidence of serum HCV antibody positivity, HCV RNA load, and HCV genotyping, as well as demographics and relevant clinical history, were investigated. Data were stratified using the multistage cluster random sampling method and further analyzed using the SPSS-20 package. RESULTS HCV antibody positivity was detected in 0.15% of the population (95% confidence interval (CI): 0.12%-0.18%). Genotype 1b (55.74%) was the dominant type. The HCV infection peaked in the age groups of 16-20, 41-50, and 61-65 years, and it was higher in males than in females (0.19% vs. 0.13%, P < 0.05). The geographical distribution of infection rates differed: 0.19% (95% CI: 0.14%-0.24%), 0.18% (95% CI: 0.13%-0.23%), and 0.06% (95% CI: 0.03-0.09%) in plain areas, islands, and valley regions, respectively. Patients with transfusion history and urban residence were associated with high HCV RNA levels (adjusted odds ratio = 11.24 and 6.20, P < 0.05). CONCLUSION The prevalence of HCV infection in this cohort from southeast China was 0.17%, which is lower than the reported 0.43% infection rate in China in 2006. This result can be (partially) explained by the improvement of blood donor screening and the successful campaign for the use of disposable syringes and needles.
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Yu G, Chi X, Wu R, Wang X, Gao X, Kong F, Feng X, Gao Y, Huang X, Jin J, Qi Y, Tu Z, Sun B, Zhong J, Pan Y, Niu J. Replication Inhibition of Hepatitis B Virus and Hepatitis C Virus in Co-Infected Patients in Chinese Population. PLoS One 2015; 10:e0139015. [PMID: 26422607 PMCID: PMC4589515 DOI: 10.1371/journal.pone.0139015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/07/2015] [Indexed: 02/07/2023] Open
Abstract
Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections contributes to a substantial proportion of liver disease worldwide. The aim of this study was to assess the clinical and virological features of HBV-HCV co-infection. Methods Demographic data were collected for 3238 high-risk people from an HCV-endemic region in China. Laboratory tests included HCV antibody and HBV serological markers, liver function tests, and routine blood analysis. Anti-HCV positive samples were analyzed for HCV RNA levels and subgenotypes. HBsAg-positive samples were tested for HBV DNA. Results A total of 1468 patients had chronic HCV and/or HBV infections. Among them, 1200 individuals were classified as HCV mono-infected, 161 were classified as HBV mono-infected, and 107 were classified as co-infected. The HBV-HCV co-infected patients not only had a lower HBV DNA positive rate compared to HBV mono-infected patients (84.1% versus 94.4%, respectively; P<0.001). The median HCV RNA levels in HBV-HCV co-infected patients were significantly lower than those in the HCV mono-infected patients (1.18[Interquartile range (IQR) 0–5.57] versus 5.87[IQR, 3.54–6.71] Log10 IU/mL, respectively; P<0.001). Furthermore, co-infected patients were less likely to have detectable HCV RNA levels than HCV mono-infected patients (23.4% versus 56.5%, respectively; P<0.001). Those HBV-HCV co-infected patients had significantly lower median HBV DNA levels than those mono-infected with HBV (1.97[IQR, 1.3–3.43] versus 3.06[IQR, 2–4.28] Log10 IU/mL, respectively; P<0.001). The HBV-HCV co-infection group had higher ALT, AST, ALP, GGT, APRI and FIB-4 levels, but lower ALB and total platelet compared to the HBV mono-infection group, and similar to that of the HCV mono-infected group. Conclusion These results suggest that co-infection with HCV and HBV inhibits the replication of both viruses. The serologic results of HBV-HCV co-infection in patients suggests more liver injury compared to HBV mono-infected patients, but is similar to HCV mono-infection.
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Affiliation(s)
- Ge Yu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Xiumei Chi
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- Key Laboratory of Zoonosis Research, Ministry Education, Jilin University, Changchun, Jilin, China; Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, Jilin Province, China
| | - Ruihong Wu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- Key Laboratory of Zoonosis Research, Ministry Education, Jilin University, Changchun, Jilin, China; Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, Jilin Province, China
| | - Xiaomei Wang
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- Key Laboratory of Zoonosis Research, Ministry Education, Jilin University, Changchun, Jilin, China; Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, Jilin Province, China
| | - Xiuzhu Gao
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- Key Laboratory of Zoonosis Research, Ministry Education, Jilin University, Changchun, Jilin, China; Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, Jilin Province, China
| | - Fei Kong
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Xiangwei Feng
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- Key Laboratory of Zoonosis Research, Ministry Education, Jilin University, Changchun, Jilin, China; Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, Jilin Province, China
| | - Yuanda Gao
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- Key Laboratory of Zoonosis Research, Ministry Education, Jilin University, Changchun, Jilin, China; Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, Jilin Province, China
| | - Xinxing Huang
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jinglan Jin
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yue Qi
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Zhengkun Tu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Bing Sun
- Institute Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Jin Zhong
- Institute Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yu Pan
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- * E-mail: (YP); (JQN)
| | - Junqi Niu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China
- * E-mail: (YP); (JQN)
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Caccamo G, Saffioti F, Raimondo G. Hepatitis B virus and hepatitis C virus dual infection. World J Gastroenterol 2014; 20:14559-14567. [PMID: 25356020 PMCID: PMC4209523 DOI: 10.3748/wjg.v20.i40.14559] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 03/24/2014] [Accepted: 05/19/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) and hepatitis C virus (HCV) share common mode of transmission and both are able to induce a chronic infection. Dual HBV/HCV chronic coinfection is a fairly frequent occurrence, especially in high endemic areas and among individuals at high risk of parenterally transmitted infections. The intracellular interplay between HBV and HCV has not yet been sufficiently clarified, also due to the lack of a proper in vitro cellular model. Longitudinal evaluation of serum HBV DNA and HCV RNA amounts has revealed that complex virological profiles may be present in coinfected patients. Dual HBV/HCV infection has been associated to a severe course of the liver disease and to a high risk of developing hepatocellular carcinoma. Despite the clinical importance, solid evidence and clear guidelines for treatment of this special population are still lacking. This review summarizes the available data on the virological and clinical features as well as the therapeutic options of the dual HBV/HCV infection, and highlights the aspects that need to be better clarified.
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MESH Headings
- Antiviral Agents/therapeutic use
- Carcinoma, Hepatocellular/diagnosis
- Carcinoma, Hepatocellular/epidemiology
- Carcinoma, Hepatocellular/prevention & control
- Carcinoma, Hepatocellular/virology
- Coinfection
- Disease Progression
- Hepacivirus/drug effects
- Hepacivirus/pathogenicity
- Hepatitis B virus/drug effects
- Hepatitis B virus/pathogenicity
- Hepatitis B, Chronic/diagnosis
- Hepatitis B, Chronic/drug therapy
- Hepatitis B, Chronic/epidemiology
- Hepatitis B, Chronic/virology
- Hepatitis C, Chronic/diagnosis
- Hepatitis C, Chronic/drug therapy
- Hepatitis C, Chronic/epidemiology
- Hepatitis C, Chronic/virology
- Host-Pathogen Interactions
- Humans
- Liver Neoplasms/diagnosis
- Liver Neoplasms/epidemiology
- Liver Neoplasms/prevention & control
- Liver Neoplasms/virology
- Risk Assessment
- Risk Factors
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Zampino R, Coppola N, Cirillo G, Boemio A, Minichini C, Marrone A, Stanzione M, Starace M, Durante-Mangoni E, Sagnelli E, Restivo L, Salzillo G, Fascione MC, Nevola R, Giudice EMD, Adinolfi LE. Insulin resistance and steatosis in HBV-HCV co-infected patients: Role of PNPLA3 polymorphisms and impact on liver fibrosis progression. World J Hepatol 2014; 6:677-684. [PMID: 25276284 PMCID: PMC4179147 DOI: 10.4254/wjh.v6.i9.677] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/08/2014] [Accepted: 08/31/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate steatosis, insulin resistance (IR) and patatin-like phospholipase domain-containing 3 (PNPLA3) and their relation to disease progression in hepatitis B and C viruses (HCV-HBV) co-infected patients.
METHODS: Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled: 66 had HBV-HCV, 66 HBV and 198 HCV infection. Prevalence of steatosis, IR and PNPLA3 polymorphisms and their relation to anthropometric, biochemical, virological and histological parameters were evaluated.
RESULTS: Prevalence of steatosis in group HBV-HCV was similar to that in HCV (47.0% vs 49.5%, respectively); group HBV showed the lowest steatosis (33.3%). Group HBV-HCV had a lesser degree of steatosis than HCV (P = 0.016), lower HCV RNA levels (P = 0.025) and lower prevalence and degree of IR (P = 0.01). PNPLA3 polymorphisms were associated with steatosis. Group HBV-HCV showed higher levels of liver fibrosis than group HCV (P = 0.001), but similar to that observed in HBV group. In HBV-HCV group, liver fibrosis was not associated with steatosis, IR or PNPLA3. HBV infection was the independent predictor of advanced liver fibrosis.
CONCLUSION: HBV-HCV co-infected patients have lower degree of hepatic steatosis, IR and HCV RNA than HCV mono-infected; co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance.
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Vedham V, Divi RL, Starks VL, Verma M. Multiple infections and cancer: implications in epidemiology. Technol Cancer Res Treat 2013; 13:177-94. [PMID: 23919392 DOI: 10.7785/tcrt.2012.500366] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Approximately 18% of the global cancer burden has been attributed to infectious agents, with estimates ranging from 7% in developed countries to about 22% in developing countries. Chronic infections caused by the hepatitis B and C viruses, human papilloma viruses (HPV), and Helicobacter pylori (H. pylori) are reported to be responsible for approximately 15% of all human cancers. Interestingly, although many of the infectious agents that have been associated with cancer--such as HPV, Epstein-Barr virus (EBV), and H. pylori--are highly prevalent in the world, most infected individuals do not develop cancer but remain lifelong carriers. Malignancies associated with infectious agents may result from prolonged latency as a result of chronic infections. Pathogenic infections are necessary but are not sufficient for cancer initiation or progression. Cancer initiation may require additional cofactors, including secondary infections. Therefore, in patients with chronic infection with one agent, secondary co-infection with another agent may serve as an important co-factor that may cause cancer initiation and progression. Additionally, opportunistic co-infections could significantly inhibit response to cancer treatment and increase cancer mortality. Co-infections are relatively common in areas with a high prevalence of infectious agents, especially in developing countries. These co-infections can cause an imbalance in the host immune system by affecting persistence of and susceptibility to malignant infections. Several articles have been published that focus on infectious agents and cancer. In this article, we discuss the role of infectious agents in malignancies, highlight the role of multiple/co-infections in cancer etiology, and review implications for cancer epidemiology.
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Affiliation(s)
- Vidya Vedham
- Methods and Technologies Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health (NIH), 6130 Executive Boulevard, Suite 5100, Bethesda, MD 20892-7324, USA.
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Sheahan T, Jones CT, Ploss A. Advances and challenges in studying hepatitis C virus in its native environment. Expert Rev Gastroenterol Hepatol 2010; 4:541-50. [PMID: 20932139 DOI: 10.1586/egh.10.53] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Approximately 2% of the worldwide population is infected with hepatitis C virus (HCV), the major causative agent of non-A, non-B hepatitis. Although substantial progress has been made in developing tools to dissect the viral life cycle, most in vitro studies rely on hepatoma cell lines, which are functionally disparate from the natural in vivo target of the virus – hepatocytes. To gain insights into virus–host interactions, there is a need for HCV-model systems that more closely mimic the physiological environment of the liver. Here, we discuss recent advances in culture and detection systems that facilitate the study of HCV in primary cells. Use of these new models may help bridge the gap between in vitro studies and clinical research.
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Affiliation(s)
- Timothy Sheahan
- Center for the Study of Hepatitis C, The Rockefeller University, 1230 York Avenue, Box 64, New York, NY 10065, USA
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Abstract
IMPORTANCE OF THE FIELD Hepatitis B (HBV) and hepatitis C (HCV) virus infections are among the most common causes of advanced chronic liver disease worldwide. HBV/HCV coinfection is not uncommon with an estimated 7 - 20 million individuals affected worldwide. Patients with HBV/HCV coinfection have an increased risk for cirrhosis, hepatocellular carcinoma (HCC) and even death. AREAS COVERED IN THIS REVIEW The pathophysiology of HBV/HCV coinfection is complex, as different patterns of virological dominance may occur, which can even fluctuate over time. Recently, combination of pegylated interferon (PEG-IFN) plus ribavirin has been explored in HBV/HCV coinfected patients who are positive for HCV-RNA. HBV polymerase inhibitors may be indicated if HBV-DNA concentrations are above 2000 IU/ml. In this review, we summarize the epidemiology, viral interaction, its clinical features and the available treatment options. WHAT THE READER WILL GAIN Insights into viral interaction of HBV/HCV coinfection and treatment individualization strategies are provided in the review. TAKE HOME MESSAGE Detailed serological and virological evaluations are required for HBV/HCV coinfected patients before initiation of antiviral therapy. At present, PEG-IFN-alpha plus ribavirin should be the treatment of choice in patients with dominant HCV replication. However, HBV rebound may occur after elimination of HCV, and thus close monitoring for both viruses is recommended even for patients with initially suppressed HBV-DNA.
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Affiliation(s)
- Andrej Potthoff
- Hannover Medical School, Medizinische Hochschule Hannover, Department of Gastroenterology, Hepatology and Endocrinology, Carl Neuberg Str. 1, D-30625 Hannover, Germany
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Manzia TM, Di Paolo D, Sforza D, Toti L, Angelico R, Brega A, Angelico M, Tisone G. Liver transplantation for hepatitis B and C virus-related cirrhosis: mid-term results. Transplant Proc 2010; 42:1200-3. [PMID: 20534261 DOI: 10.1016/j.transproceed.2010.03.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT) is almost universal; cirrhosis develops in up to 30% of cases. Currently there is interest in the midterm outcomes of HCV patients with concomitant hepatitis B virus (HBV) infection among OLT recipients. We therefore retrospectively analyzed our database of patients who underwent OLT for HCV-HBV-related cirrhosis. Between April 1992 and December 2008, 350 patients underwent OLT, including 20 (5.7%) transplanted for HBV-HCV cirrhosis. We assessed patient and graft survivals at 1 and 5 years, as well as the progression of fibrosis. Protocol liver biopsies were available yearly after OLT. The survival curves were analyzed by the Kaplan-Meier approach and chronic hepatitis evaluated according to the Ishak scoring system. At a median follow-up of 68.4 +/- 53 months, the 1- and 5-year patient and graft survival rates were 80% and 70%, respectively. The 5-year fibrosis progression rate was 0.17 +/- 0.08 units of fibrosis. The only patient who developed histologic cirrhosis within 10 years of follow-up showed a lamivudine-resistant HBV recurrence. Patients transplanted for HBV-HCV coinfection showed a lower fibrosis progression rate compared with HCV monoinfected subjects.
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Affiliation(s)
- T M Manzia
- Transplant Unit, Department of Surgery, University of Rome Tor Vergata, Rome, Italy.
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Potthoff A, Berg T, Wedemeyer H. Late hepatitis B virus relapse in patients co-infected with hepatitis B virus and hepatitis C virus after antiviral treatment with pegylated interferon-a2b and ribavirin. Scand J Gastroenterol 2010; 44:1487-90. [PMID: 19900055 DOI: 10.3109/00365520903329585] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
HBV DNA and HCV RNA viremia levels may fluctuate over time in HBV-HCV-coinfected patients. Long-term follow-up data of more than 6 months after PEG-IFNa + ribavirin treatment of HBV/HCV co-infection are lacking. We here report that HBV may reactivate, even after a period of years, in HBV- and HCV-co-infected patients if HCV is cleared by antiviral therapy. In contrast, a sustained response concerning HCV is durable. We recommend long-term monitoring of HBV/HCV-co-infected patients after IFN a-based therapies.
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Affiliation(s)
- A Potthoff
- Department of Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
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12
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Lu J, Zhou Y, Lin X, Jiang Y, Tian R, Zhang Y, Wu J, Zhang F, Zhang Y, Wang Y, Bi S. General epidemiological parameters of viral hepatitis A, B, C, and E in six regions of China: a cross-sectional study in 2007. PLoS One 2009; 4:e8467. [PMID: 20041146 PMCID: PMC2794385 DOI: 10.1371/journal.pone.0008467] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 12/03/2009] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Viral hepatitis is a serious health burden worldwide. To date, few reports have addressed the prevalence of hepatitis A, B, C, and E in China. Therefore, the general epidemiological parameters of viral hepatitis remain unknown. PRINCIPAL FINDINGS In this cross-sectional study, we performed a serological prevalence analysis of viral hepatitis A, B, C, and E in 8,762 randomly selected Chinese subjects, which represented six areas of China. The overall prevalence of anti-Hepatitis C virus antibody (anti-HCV) was 0.58%, which was much lower than was estimated by WHO. The prevalences of Hepatitis B virus surface antigen (HBsAg), anti-Hepatitis B virus surface protein antibody (HBsAb), and anti-Hepatitis B virus core protein antibody (HBcAb) were 5.84%, 41.31%, and 35.92%, respectively, whereas in the group of subjects less than 5 years old, these prevalences were 1.16%, 46.77%, and 8.69% respectively, which suggests that the Hepatitis B virus (HBV)-carrier population is decreasing, and the nationwide HBV vaccine program has contributed to the lowered HBV prevalence in the younger generation in China. Meanwhile, a large deficit remains in coverage provided by the national HBV immune program. In addition, our data suggested the possibility that HBsAb may not last long enough to protect people from HBV infection throughout life. The overall prevalence of anti-Hepatitis A virus antibody (anti-HAV) and anti-Hepatitis E virus antibody (anti-HEV) were as high as 72.87% and 17.66%, respectively. The indices increased with age, which suggests that a large proportion of Chinese adults are protected by latent infection. Furthermore, the pattern of HEV infection was significantly different among ethnic groups in China. CONCLUSIONS Our study provided much important information concerning hepatitis A, B, C, and E prevalence in China and will contribute to worldwide oversight of viral hepatitis.
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MESH Headings
- Adolescent
- Adult
- Biomarkers/blood
- Child
- Child, Preschool
- China/epidemiology
- Cross-Sectional Studies
- Female
- Geography
- Hepacivirus/immunology
- Hepatitis A/blood
- Hepatitis A/epidemiology
- Hepatitis A/immunology
- Hepatitis A/virology
- Hepatitis A Antibodies/immunology
- Hepatitis A Virus, Human/immunology
- Hepatitis B/blood
- Hepatitis B/epidemiology
- Hepatitis B/immunology
- Hepatitis B/virology
- Hepatitis B virus/immunology
- Hepatitis C/blood
- Hepatitis C/epidemiology
- Hepatitis C/immunology
- Hepatitis C/virology
- Hepatitis C Antibodies/immunology
- Hepatitis E/blood
- Hepatitis E/epidemiology
- Hepatitis E/immunology
- Hepatitis E/virology
- Hepatitis E virus/immunology
- Hepatitis, Viral, Human/blood
- Hepatitis, Viral, Human/epidemiology
- Hepatitis, Viral, Human/immunology
- Hepatitis, Viral, Human/virology
- Humans
- Male
- Middle Aged
- Prevalence
- Young Adult
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Affiliation(s)
- Jian Lu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Yongdong Zhou
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Xiaojing Lin
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Yongzhen Jiang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Ruiguang Tian
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Yonghui Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Jia Wu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Fengwei Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Yong Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Yue Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
| | - Shengli Bi
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xuanwu District, Beijing, People's Republic of China
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Bellecave P, Gouttenoire J, Gajer M, Brass V, Koutsoudakis G, Blum HE, Bartenschlager R, Nassal M, Moradpour D. Hepatitis B and C virus coinfection: a novel model system reveals the absence of direct viral interference. Hepatology 2009; 50:46-55. [PMID: 19333911 DOI: 10.1002/hep.22951] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
UNLABELLED Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) has been associated with severe liver disease and frequent progression to cirrhosis and hepatocellular carcinoma. Clinical evidence suggests reciprocal replicative suppression of the two viruses, or viral interference. However, interactions between HBV and HCV have been difficult to study due to the lack of appropriate model systems. We have established a novel model system to investigate interactions between HBV and HCV. Stable Huh-7 cell lines inducibly replicating HBV were transfected with selectable HCV replicons or infected with cell culture-derived HCV. In this system, both viruses were found to replicate in the same cell without overt interference. Specific inhibition of one virus did not affect the replication and gene expression of the other. Furthermore, cells harboring replicating HBV could be infected with cell culture-derived HCV, arguing against superinfection exclusion. Finally, cells harboring replicating HBV supported efficient production of infectious HCV. CONCLUSION HBV and HCV can replicate in the same cell without evidence for direct interference in vitro. Therefore, the viral interference observed in coinfected patients is probably due to indirect mechanisms mediated by innate and/or adaptive host immune responses. These findings provide new insights into the pathogenesis of HBV-HCV coinfection and may contribute to its clinical management in the future.
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Affiliation(s)
- Pantxika Bellecave
- Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
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