Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2016; 22(42): 9427-9436
Published online Nov 14, 2016. doi: 10.3748/wjg.v22.i42.9427
Occult hepatitis B virus infection is not associated with disease progression of chronic hepatitis C virus infection
Junhyeon Cho, Sang Soo Lee, Yun Suk Choi, Yejoo Jeon, Jung Wha Chung, Joo Yeong Baeg, Won Keun Si, Eun Sun Jang, Jin-Wook Kim, Sook-Hyang Jeong
Junhyeon Cho, Yun Suk Choi, Yejoo Jeon, Jung Wha Chung, Joo Yeong Baeg, Won Keun Si, Eun Sun Jang, Jin-Wook Kim, Sook-Hyang Jeong, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do 463-707, South Korea
Sang Soo Lee, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Gyeonggi-do 463-707, South Korea
Author contributions: Cho JH, Lee SS and Jeong SH designed the study; Jang ES, Kim JW and Jeong SH enrolled the patients; Cho JH, Lee SS, Choi YS, Jeon Y, Kim JW, Baeg JY and Si WK collected the data; Cho JH, Lee SS and Jeong SH analyzed and interpreted the data; all authors read and approved the final manuscript; Cho JH and Lee SS contributed equally to this manuscript.
Supported by the Korea Centers for Disease Control and Prevention, No. 4800-4859-304; and the Seoul National University Bundang Hospital, No. 02-2014-026.
Institutional review board statement: The project was approved by the Institutional Review Board of Seoul National University Bundang Hospital.
Informed consent statement: Informed consent was obtained prior to enrollment of subjects.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The collected data were entered into the electronic case report form at the Korean HCV cohort study group homepage (http://www.hcvcohort.or.kr/).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sook-Hyang Jeong, MD, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumiro 173, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, South Korea. jsh@snubh.org
Telephone: +82-31-7877029 Fax: +82-31-7874052
Received: June 30, 2016
Peer-review started: July 1, 2016
First decision: August 8, 2016
Revised: August 18, 2016
Accepted: September 6, 2016
Article in press: September 6, 2016
Published online: November 14, 2016
Abstract
AIM

To clarify the prevalence of occult hepatitis B virus (HBV) infection (OBI) and the association between OBI and liver disease progression, defined as development of liver cirrhosis or hepatocellular carcinoma (HCC), worsening of Child-Pugh class, or mortality in cases of chronic hepatitis C virus (HCV) infection.

METHODS

This prospective cohort study enrolled 174 patients with chronic HCV infection (chronic hepatitis, n = 83; cirrhosis, n = 47; HCC, n = 44), and evaluated disease progression during a mean follow-up of 38.7 mo. OBI was defined as HBV DNA positivity in 2 or more different viral genomic regions by nested polymerase chain reaction using 4 sets of primers in the S, C, P and X open reading frame of the HBV genome.

RESULTS

The overall OBI prevalence in chronic HCV patients at enrollment was 18.4%, with 16.9%, 25.5% and 13.6% in the chronic hepatitis C, liver cirrhosis and HCC groups, respectively (P = 0.845). During follow-up, 52 patients showed disease progression, which was independently associated with aspartate aminotransferase > 40 IU/L, Child-Pugh score and sustained virologic response (SVR), but not with OBI positivity. In 136 patients who were not in the SVR state during the study period, OBI positivity was associated with neither disease progression, nor HCC development.

CONCLUSION

The prevalence of OBI in chronic HCV patients was 18.4%, and OBI was not associated with disease progression in South Koreans.

Keywords: Hepatitis B virus, Hepatitis C virus, Disease control, Oncogenesis

Core tip: Whether occult hepatitis B virus (HBV) infection affects the outcomes of chronic hepatitis C virus infection is controversial. This prospective observational study aimed to clarify the association between occult HBV infection and liver disease progression defined as development of liver cirrhosis, worsening of Child-Pugh class, hepatocellular carcinoma or mortality in patients with chronic hepatitis C infection in South Korea.