ABSTRACT
Background and study aims: Data about dual hepatitis C [HCV] and B [HBV] co-infection are still scarce, especially in endemic areas such as Egypt. Therefore, we aimed to characterise the virologic and histologic pattern of dual B/C co-infection in a tertiary care centre in Egypt
Patients and methods: After obtaining approval from the review board, a retrospective design to evaluate the data registry between January 2009 and December 2012 of patients with dual HCV and HBV seropositivity [BC-group] at the Viral Hepatitis Unit in Ministry of Health and Assiut University Hospital, Egypt was conducted. Data for hepatitis B e antigen [HBe-Ag] and anti-HB core status, anti-hepatitis delta virus [anti-HDV], HBV-DNA and HCV-RNA assays and liver biopsy [METAVIR scoring] results were collected. Two other matched groups of mono-HCV [C-group] and HBV [B-group] were selected as controls. All patients were naive for antiviral therapy
Results: A total of 3300 patients were enrolled. Dual infection was observed in 25 [0.7%] patients [all males, mean = 35.2 +/- 10.2 years]. Four patients [16%] were HBe-Ag-positive. Six [24%] patients were HBV-DNA-negative and all were positive for HCV RNA. Between groups, raised alanine aminotransferase [ALT] was found in 76%, 41.7% and 49.2% of the BC, B and C groups, respectively [p = 0.023]. HBV DNA >2000 IU ml[-1] was more in the B-group than in the BC-group [63.9% vs. 36%; p = 0.042] and HCV RNA >800,000 IU ml[-1] was more in the BC-group than in the C-group [28% vs. 12.3%; p = 0.009]. Histologically, there is no statistical significant difference between the three groups
Conclusion: Dual hepatitis B/C infection is not uncommon and their virologic and histologic profile is modest. Further evaluation with regard to treatment and long-term follow-up is warranted