Replication Inhibition of Hepatitis B Virus and Hepatitis C Virus in Co-Infected Patients in Chinese Population

PLoS One. 2015 Sep 30;10(9):e0139015. doi: 10.1371/journal.pone.0139015. eCollection 2015.

Abstract

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections contributes to a substantial proportion of liver disease worldwide. The aim of this study was to assess the clinical and virological features of HBV-HCV co-infection.

Methods: Demographic data were collected for 3238 high-risk people from an HCV-endemic region in China. Laboratory tests included HCV antibody and HBV serological markers, liver function tests, and routine blood analysis. Anti-HCV positive samples were analyzed for HCV RNA levels and subgenotypes. HBsAg-positive samples were tested for HBV DNA.

Results: A total of 1468 patients had chronic HCV and/or HBV infections. Among them, 1200 individuals were classified as HCV mono-infected, 161 were classified as HBV mono-infected, and 107 were classified as co-infected. The HBV-HCV co-infected patients not only had a lower HBV DNA positive rate compared to HBV mono-infected patients (84.1% versus 94.4%, respectively; P < 0.001). The median HCV RNA levels in HBV-HCV co-infected patients were significantly lower than those in the HCV mono-infected patients (1.18[Interquartile range (IQR) 0-5.57] versus 5.87[IQR, 3.54-6.71] Log10 IU/mL, respectively; P < 0.001). Furthermore, co-infected patients were less likely to have detectable HCV RNA levels than HCV mono-infected patients (23.4% versus 56.5%, respectively; P < 0.001). Those HBV-HCV co-infected patients had significantly lower median HBV DNA levels than those mono-infected with HBV (1.97[IQR, 1.3-3.43] versus 3.06[IQR, 2-4.28] Log10 IU/mL, respectively; P < 0.001). The HBV-HCV co-infection group had higher ALT, AST, ALP, GGT, APRI and FIB-4 levels, but lower ALB and total platelet compared to the HBV mono-infection group, and similar to that of the HCV mono-infected group.

Conclusion: These results suggest that co-infection with HCV and HBV inhibits the replication of both viruses. The serologic results of HBV-HCV co-infection in patients suggests more liver injury compared to HBV mono-infected patients, but is similar to HCV mono-infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • China
  • Cohort Studies
  • Coinfection / blood
  • Coinfection / pathology
  • Coinfection / virology*
  • Female
  • Hepacivirus / physiology*
  • Hepatitis B / blood
  • Hepatitis B / complications
  • Hepatitis B / pathology
  • Hepatitis B / virology*
  • Hepatitis B virus / physiology*
  • Hepatitis C / blood
  • Hepatitis C / complications
  • Hepatitis C / pathology
  • Hepatitis C / virology*
  • Humans
  • Liver / pathology
  • Male
  • Middle Aged
  • Virus Replication*

Grants and funding

The study was sponsored by National Science and Technology Major Project 2014ZX10002002 to Junqi Niu, National Science and Technology Major Project 2013ZX10002008 to Junqi Niu, National Natural Science Foundation of China 81373057 to Junqi Niu, National Basic Research Program of China (973 Program) 2015CB554300 to Jin Zhong, National Natural Science Foundation of China 81202377 to Xiumei Chi, National Natural Science Foundation of China 81301472 to Xiaomei Wang, and National Natural Science Foundation of China 81301415 to Ruihong Wu. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.