Hepatitis B surface antigen loss and hepatocellular carcinoma development in patients with dual hepatitis B and C infection
Journal
Medicine (United States)
Journal Volume
95
Journal Issue
10
Date Issued
2016
Author(s)
Yang W.-T.
Wu L.-W
Wang C.-C
Kuo S.F.-T
Abstract
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are 2 major causes of chronic viral hepatitis. It is still unclear how HCV coinfection affects HBV replication and clinical outcomes in HBV/HCV coinfected patients. We conducted a longitudinal study, which enrolled 111 patients with HBV/HCV coinfection and 111 propensity score-matched controls with HBV monoinfection. Both groups had comparable baseline age, sex, fibrosis stage, levels of HBV DNA, and HBV surface antigen (HBsAg). The HCV coinfection and other host/viral factors were correlated with various outcomes, including HBsAg loss and cirrhosis/hepatocellular carcinoma (HCC) development. After a 10-year follow-up, we found that HCV coinfection itself was not associated with HBsAg loss. However, coinfected patients with alanine aminotransferase (ALT) level >80 U/L had a higher chance of HBsAg loss than those with ALT level -80 U/L [hazard ratio (95% confidence interval): 4.41 (1.75-11.15)] or matched controls with HBV monoinfection [hazard ratio (95% confidence interval): 3.40 (1.54-7.50)]. Besides, both HCV coinfection and higher ALT levels were associated with higher HCC risks and the HCC risks remained even after HBsAg loss in HBV/HCV con-infected patient. HCV coinfection is not associated with HBsAg loss. A higher ALT level is a major determinant of HBsAg loss in patients with HBV/HCV coinfection. Both HCV coinfection and a higher ALT level were independent risk factors of HCC. Copyright ? 2016 Wolters Kluwer Health, Inc. All rights reserved.
SDGs
Other Subjects
alanine aminotransferase; hepatitis B surface antigen; virus DNA; virus RNA; hepatitis B surface antigen; hepatitis C antigen; virus RNA; adult; alanine aminotransferase blood level; Article; cancer incidence; cancer prognosis; cancer risk; carcinogenesis; clinical feature; controlled study; female; follow up; hazard ratio; hepatitis B; Hepatitis B virus; hepatitis C; Hepatitis C virus; human; liver cell carcinoma; liver cirrhosis; major clinical study; male; middle aged; mixed infection; outcome assessment; priority journal; propensity score; viral clearance; virus load; virus replication; aged; Carcinoma, Hepatocellular; complication; forecasting; genetics; genotype; Hepacivirus; hepatitis B; hepatitis C; immunology; Liver Neoplasms; mixed infection; pathology; prognosis; retrospective study; risk factor; virology; young adult; Adult; Aged; Carcinoma, Hepatocellular; Coinfection; Female; Follow-Up Studies; Forecasting; Genotype; Hepacivirus; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis C; Hepatitis C Antigens; Humans; Liver Neoplasms; Male; Middle Aged; Prognosis; Retrospective Studies; Risk Factors; RNA, Viral; Young Adult
Publisher
Lippincott Williams and Wilkins
Type
journal article