Occult hepatitis B infection in egyptian chronic hepatitis C patients: prevalence, impact on pegylated interferon/ribavirin therapy

Mohamed H Emara,Maged M Bahgat,Lamiaa A Mohamed,Nahla E El-Gammal

doi:10.1186/1743-422x-7-324

Abstract

BackgroundChronic HCV infection combined with occult hepatitis B infection has been associated with liver enzymes flare, advanced hepatic fibrosis and cirrhosis, poor response to standard interferon-α, and increased risk of HCC. This study aimed to elucidate the prevalence of occult hepatitis B infection in Egyptian chronic HCV patients, and to clarify its role in non-response of those patients to pegylated interferon/ribavirin therapy. This study enrolled 155 consecutive chronic HCV patients under pegylated interferon/ribavirin therapy. All patients were exposed to clinical assessment, biochemical, histological and virological examinations. HBV parameters (HBV DNA, anti-HBc, anti-HBs) and patients' response status to the combination therapy were determined.ResultsIn this study, occult hepatitis B infection occurs in 3.9% of Egyptian chronic HCV patients; tends to affect younger age patients, associated with higher base line HCV viral load, less hepatic fibrosis than monoinfected patients. This occult hepatitis B infection is not a statistically significant cause of non-response to pegylated interferon/ribavirin therapy. Anti-HBs was not associated with any biochemical, histological or virological abnormalities in those patients, contrary to low response rate to therapy and higher HCV viral load that was observed with anti-HBc.ConclusionsDetection of HBV DNA in HBsAg negative chronic HCV patients plays a non significant role in non-response of Egyptian patients to pegylated interferon/ribavirin therapy.

Highlights

Chronic HCV infection combined with occult hepatitis B infection has been associated with liver enzymes flare, advanced hepatic fibrosis and cirrhosis, poor response to standard interferon-a, and increased risk of HCC
The currently recommended therapy for chronic HCV is the combination of pegylated interferon alpha and ribavirin (Peg-IFN/RBV) that proved to be superior to standard interferon alpha and ribavirin [3]
In chronic HCV infection, the presence of Occult hepatitis B virus infection (OBI) has been associated with liver enzymes flare [8], increased severity of liver disease towards advanced fibrosis and cirrhosis [6,9], poor response to standard interferon-a in many [6,9,10,11,12], but not all [13] studies, and increased risk of HCC [14,15]

Summary

Introduction

Chronic HCV infection combined with occult hepatitis B infection has been associated with liver enzymes flare, advanced hepatic fibrosis and cirrhosis, poor response to standard interferon-a, and increased risk of HCC. For patients with HCV genotype 4 infections (the prevalent genotype in Egypt), combination treatment with pegylated interferon alpha and weight based ribavirin administered for 48 weeks seems to be an. In chronic HCV infection, the presence of OBI has been associated with liver enzymes flare [8], increased severity of liver disease towards advanced fibrosis and cirrhosis [6,9], poor response to standard interferon-a in many [6,9,10,11,12], but not all [13] studies, and increased risk of HCC [14,15].

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