Abstract
Hepatitis B virus/hepatitis C virus (HBV/HCV) dual infection is common among high-risk individuals. To characterize the virological and immunological features of patients with HBV/HCV dual infection, we enrolled 1,049 individuals who have been identified as injection drug users. Patients were divided into single and dual infection groups according to the serological markers. We found the average HCV RNA level was significantly lower; however, HBV viral load was significantly higher in HBV/HCV dual-infected patients (n = 42) comparing HCV single infection (n = 340) or HBV single infection (n = 136). The level of anti-HBs in patients who experienced spontaneous HBV clearance was higher than that in HCV single-infected patients with HBV spontaneous clearance. The level of anti-HCV E2 in HBV/HCV dual infection was lower than that detected in HCV single infection. Serum levels of IL-6, IL-8, and TNF-α were significantly lower in HBV/HCV dual-infected patients than in patients infected with HBV or HCV alone. Taken together, two viral replications are imbalanced in dual infected patients. The anti-HBs and anti-HCV E2 antibody production were impaired and proinflammatory IL-6, IL-8, and TNF-α also downregulated due to dual infection. These findings will help further understanding the pathogenesis of HBV/HCV dual infection.
Highlights
Hepatitis B virus/Hepatitis C virus (HBV/HCV) dual infection is common, especially in highly endemic areas and among individuals with a high risk for parenteral infections including injection drug users (IDUs) and patients on hemodialysis[1]
Patients infected with hepatitis D virus (HDV), human immunodeficiency virus (HIV), and syphilis were excluded from the study
We found that HBV DNA levels were higher and HCV viral load were lower in HBV/HCV dual infection as compared with HBV or HCV single infection
Summary
Hepatitis B virus/Hepatitis C virus (HBV/HCV) dual infection is common, especially in highly endemic areas and among individuals with a high risk for parenteral infections including injection drug users (IDUs) and patients on hemodialysis[1]. A few studies have shown that HCV replication was more robust in HBV/HCV dual infection compared with HCV single infection[8,9,10]. Compared to HBV or HCV single infection, HBV/HCV dual infection may have a more profound impact on the immunological response. Chu et al reported that the frequency and relative intensity of antibody response to HCV non-structural protein 4 were significantly diminished in HBV/HCV dual infection compared to HCV single infection[12]. HBV vaccination in chronic HCV-infected individuals has been shown to induce relatively lower anti-HBs antibody levels[25,26]. It has been shown that decreased production of IFN-γand TNF-αand elevated IL-10 levels contribute to persistent infection and disease progression[30]
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