Impact of occult hepatitis B virus infection on antiviral therapy in chronic hepatitis C patients

Abstract

Background: Occult HBV infection (OBI) can be defined by the presence of HBV-DNA in the serum of patients who are negative for HBsAg. The presence of OBI has been associated with a poor therapeutic response to alpha IFN in many, but not in all studies. Objective: The aim of our study was to assess the prevalence of OBI in the serum of Egyptian patients with CHC, and to evaluate its impact on the response to treatment with a combination of Peg-IFNα and RBV. Materials and methods: Fifty chronic HCV infected patients who were treated with Peg-IFNα once a week in combination with RBV for 48 weeks were included in this study. Patients were divided into two groups, group I which included 25 patients who achieved SVR and group II that included 25 patients who failed to achieve SVR (Non-SVR). Both patient groups were subjected to detailed questionnaire, clinical examination, routine laboratory investigations and virological studies. Results: No statistical significant difference was found in sex distribution regarding SVR and Non-SVR. The frequency of patients with low viral load has a statistically significant association with SVR patients compared to Non-SVR patients. The frequency of anti-HBc seropositivity has a statistically significant association with the Non-SVR patients compared to SVR patients. Out of 11 anti-HBc positive samples, 10 (90.9%) were positive for the pol and s genes while 9 (81.81%) were positive for the c gene. About 17 (34%) out of 50 patients included in the study were HBV-DNA positive. The frequency of HBV-DNA positive HCV patients has a statistically significant association with Non-SVR patients compared to the SVR patients (p < 0.05). Conclusion: The prevalence of OBI was higher in our CHCV patients. OBI was significantly associated with poor response to combined Peg-IFNα and RBV therapy.

Keywords

• Chronic hepatitis C
• Occult HBV infection
• Sustained virological response