Hepatitis B virus infection in Chinese patients with hepatitis C virus infection: prevalence, clinical characteristics, viral interactions and host genotypes: a nationwide cross-sectional study

Li-Bo Yan, Hui-Ying Rao, Yuan-Ji Ma, Lang Bai, En-Qiang Chen, Ling-Yao Du, Rui-Feng Yang, Lai Wei, Hong Tang, CCgenos Study Group, Li-Bo Yan, Hui-Ying Rao, Yuan-Ji Ma, Lang Bai, En-Qiang Chen, Ling-Yao Du, Rui-Feng Yang, Lai Wei, Hong Tang, CCgenos Study Group

Abstract

Objectives: Little is known about hepatitis B virus (HBV) infection in patients with hepatitis C virus (HCV) infection in China. This study aimed to evaluate the prevalence, clinical characteristics, viral interactions and host genotypes of HBV/HCV dual infection compared with HCV monoinfection.

Study design: A cross-sectional study.

Setting: China.

Participants and methods: 997 patients with HCV from 28 university-affiliated hospitals in China were enrolled in this research. Patients were divided into two subgroups.

Results: The prevalence of HBV infection in patients with HCV was 4.11% (41/997). The age-specific prevalence of HBsAg was 0.70%, 3.97% and 5.85% in groups aged 18-30, 30-50 and >50 years old (p=0.057), respectively. Patients with HBV/HCV dual infection and patients with HCV monoinfection had similar HCV viral loads (5.80±0.89 vs 5.83±1.00 log10 IU/mL, p=0.904). The dominant HCV genotype was 1b in both groups (53.65% vs 56.90%, p=0.493). The protective C allele in IL-28B (rs12979860) was also the dominant allele type in both patient groups (85.36% vs 83.99%, p=0.814). Patients with HBV/HCV dual infection had a higher ratio of liver cirrhosis and hepatic decompensation than patients with HCV monoinfection (39.02% vs 17.69%, p=0.001; 31.70% vs 12.13%, p=0.001).

Conclusions: The HBV burden was moderate in HCV-infected patients in China. Liver cirrhosis was more common in patients with HBV/HCV dual infection, suggesting the need for closer monitoring of dual-infected individuals.

Trial registration number: NCT01293279; Post-results.

Keywords: Cirrhosis; Hepatitis; Hepatitis B virus (HBV); Hepatitis C virus (HCV).

Conflict of interest statement

Conflicts of Interest: None declared.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Figures

Figure 1
Figure 1
Flow chart of this cross-sectional observational study.
Figure 2
Figure 2
Cirrhosis and fatty liver in hepatitis B virus/hepatitis C virus (HBV/HCV) dual-infected patients and HCV monoinfected patients. (A) Prevalence of cirrhosis in patients with dual HBV/HCV infection or HCV monoinfection. Numbers in the columns are the number of cirrhosis cases; *p=0.001. (B) Prevalence of fatty liver in patients with dual HBV/HCV infection or HCV monoinfection. Numbers in the columns are the number of fatty liver cases; p=0.621.

References

    1. Sievert W, Altraif I, Razavi HA et al. . A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver Int 2011;31(Suppl 2):61–80. 10.1111/j.1478-3231.2011.02540.x
    1. Saravanan S, Velu V, Nandakumar S et al. . Hepatitis B virus and hepatitis C virus dual infection among patients with chronic liver disease. J Microbiol Immunol Infect 2009;42:122–8.
    1. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009;50:661–2. 10.1002/hep.23190
    1. European Association for Study of Liver. EASL clinical practice guidelines: management of hepatitis C virus infection. J Hepatol 2014;60:392–420. 10.1016/j.jhep.2013.11.003
    1. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 2005;5:558–67. 10.1016/S1473-3099(05)70216-4
    1. Caccamo G, Saffioti F, Raimondo G. Hepatitis B virus and hepatitis C virus dual infection. World J Gastroenterol 2014;20:14559–67. 10.3748/wjg.v20.i40.14559
    1. Tyson GL, Kramer JR, Duan Z et al. . Prevalence and predictors of hepatitis B virus coinfection in a United States cohort of hepatitis C virus-infected patients. Hepatology 2013;58:538–45. 10.1002/hep.26400
    1. Bini EJ, Perumalswami PV. Hepatitis B virus infection among American patients with chronic hepatitis C virus infection: prevalence, racial/ethnic differences, and viral interactions. Hepatology 2010;51:759–66. 10.1002/hep.23461
    1. Chu CJ, Lee SD. Hepatitis B virus/hepatitis C virus coinfection: epidemiology, clinical features, viral interactions and treatment. J Gastroenterol Hepatol 2008;23:512–20. 10.1111/j.1440-1746.2008.05384.x
    1. Zarski JP, Bohn B, Bastie A et al. . Characteristics of patients with dual infection by hepatitis B and C viruses. J Hepatol 1998;28:27–33. 10.1016/S0168-8278(98)80198-0
    1. Liu CJ, Chen PJ, Chen DS. Dual chronic hepatitis B virus and hepatitis C virus infection. Hepatol Int 2009;3:517–25. 10.1007/s12072-009-9147-9
    1. Rao H, Wei L, Lopez-Talavera JC et al. . Distribution and clinical correlates of viral and host genotypes in Chinese patients with chronic hepatitis C virus infection. J Gastroenterol Hepatol 2014;29:545–53. 10.1111/jgh.12398
    1. Chen X, Xuan M, Wu D. [Study of superinfection of HBV and HCV]. Zhonghua Liu Xing Bing Xue Za Zhi 1999;20:141–3.
    1. Li W, Zhu Y, Hua Z. [Exploration on the association between the pattern of HBV markers and infection of HCV among population]. Zhonghua Liu Xing Bing Xue Za Zhi 1994;15:212–14.
    1. Zhang Q, Qi W, Wang X et al. . Epidemiology of hepatitis B and hepatitis C infections and benefits of programs for hepatitis prevention in northeastern China: a cross-sectional study. Clin Infect Dis 2016;62:305–12. 10.1093/cid/civ859
    1. Gower E, Estes C, Blach S et al. . Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 2014;61:S45–57. 10.1016/j.jhep.2014.07.027
    1. Esteban JI, Sauleda S, Quer J. The changing epidemiology of hepatitis C virus infection in Europe. J Hepatol 2008;48:148–62. 10.1016/j.jhep.2007.07.033
    1. Pawlotsky JM, Tsakiris L, Roudot-Thoraval F et al. . Relationship between hepatitis C virus genotypes and sources of infection in patients with chronic hepatitis C. J Infect Dis 1995;171:1607–10. 10.1093/infdis/171.6.1607
    1. Cui Y, Jia J. Update on epidemiology of hepatitis B and C in China. J Gastroenterol Hepatol 2013;28(Suppl 1):7–10. 10.1111/jgh.12220
    1. Su YY, Liu HX, Wang N. [Hepatitis C virus genotypes in China: a systematic review]. Zhonghua Liu Xing Bing Xue Za Zhi 2013;34:80–4.
    1. Lu L, Nakano T, He Y et al. . Hepatitis C virus genotype distribution in China: predominance of closely related subtype 1b isolates and existence of new genotype 6 variants. J Med Virol 2005;75:538–49. 10.1002/jmv.20307
    1. Dong ZX, Zhou HJ, Xiang XG et al. . IL28B genetic variations are associated with treatment response of patients with chronic hepatitis C in a Chinese Han population. J Dig Dis 2015;16:90–7. 10.1111/1751-2980.12202
    1. Mi Y, Gao YT, Jiao XL et al. . The role of interleukin-28b gene polymorphisms in Chinese patients with chronic hepatitis C treated with pegylated interferon and ribavirin. Hepat Mon 2014;14:e18793 10.5812/hepatmon.18793
    1. Liao XW, Ling Y, Li XH et al. . Association of genetic variation in IL28B with hepatitis C treatment-induced viral clearance in the Chinese Han population. Antivir Ther 2011;16:141–7. 10.3851/IMP1703
    1. Afdhal N, Zeuzem S, Kwo P et al. . Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. N Engl J Med 2014;370:1889–98. 10.1056/NEJMoa1402454
    1. Abergel A, Asselah T, Metivier S et al. . Ledipasvir-sofosbuvir in patients with hepatitis C virus genotype 5 infection: an open-label, multicentre, single-arm, phase 2 study. Lancet Infect Dis 2016;16:459–64. 10.1016/S1473-3099(15)00529-0
    1. Abergel A, Metivier S, Samuel D et al. . Ledipasvir plus sofosbuvir for 12 weeks in patients with hepatitis C genotype 4 infection. Hepatology 2016;64:1049–56. 10.1002/hep.28706
    1. Sagnelli E, Pasquale G, Coppola N et al. . Influence of chronic coinfection with hepatitis B and C virus on liver histology. Infection 2004;32:144–8. 10.1007/s15010-004-3080-6
    1. Villari D, Pernice M, Spinella S et al. . Chronic hepatitis in patients with active hepatitis B virus and hepatitis C virus combined infections: a histological study. Am J Gastroenterol 1995;90:955–8.
    1. Coppola N, Onorato L, Pisaturo M et al. . Role of occult hepatitis B virus infection in chronic hepatitis C. World J Gastroenterol 2015;21:11931–40. 10.3748/wjg.v21.i42.11931
    1. Xie Q, Jiang X, Zhang Y et al. . Intrahepatic hepatitis B virus covalently closed circular DNA correlation with serum HBV DNA, serum HBsAg, alanine aminotransferase and age. Zhonghua Gan Zang Bing Za Zhi 2015;23:418–21.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa