[Features of combined (HBV/HCV-infection) viral lesion of the liver]

Abstract

Aim: To study clinical, biochemical features, course of combined viral hepatitides, dominant viral activity in combination HBV/HCV infection.

Material and methods: A total of 37 patients with HbsAg and anti-HCV, 23 patients with chronic hepatitis C and 48 patients with chronic hepatitis B were examined (the study and comparison groups, respectively). 67 HbsAg carriers with normal,hepatic parameters (no clinical symptoms, normal transaminase activity) served controls.

Results: In patients with parallel detection of HbsAg and anti-HCV detectability of HBV-DNA was 8.1% while HCVrNA was detected in 84% cases. Half the patients with HbeAg positive HBV had seroconversion 1.5-2 years after HCV infection. Documented HCV infection in HBV patients leads to elimination of one of the viruses (HBV more frequently) in more than 50% cases. HCV infection may induce seroconversion of HbeAg. Biochemical parameters (bilirubin, AIAT, AP, gamma HTP of blood) in patients with mixed infection compared with those with mono-infection were 1.5 times higher. In mixed infection cytokines (TNF-alpha, IL-1 beta, IL-6, IL-8, TGF-lbeta) levels were also higher, the diameter of the portal vein was larger (16.9 +/- 0.5 mm). Conclusion. In mixed viral infection there are marked changes in clinico-biochemical, morphological and hemodynamic indices with a clear trend to early formation of portal hypertension with significant alterations in the esophago-gastroduodenal zone.