Co-infection with hepatitis B and C viruses: current state of the problem
https://doi.org/10.31146/1682-8658-ecg-221-1-67-74
Abstract
Co-infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) is a complex clinical disease with an estimated worldwide prevalence of 1-15%. The transmission routes for HCV and HBV are similar. During co-infection, four serological profiles are observed: codominant, HCV dominant, HBV dominant and non-replicative. Although both HBV and HCV replicate in hepatocytes, their life cycles are quite different. Viral replication in co-infected cells is characterized by the dominance of HCV replication over HBV replication. Three theories of interaction between HCV and HBV are discussed. There are no established recommendations for the treatment of HBV/HCV co-infection. Treatment of chronic hepatitis C without HBV suppression increases the risk of HBV reactivation. In the review, we evaluate studies of both direct-acting antivirals and interferon-based therapies. Screening and prevention of co-infection are important to prevent serious HBV reactivation.
About the Authors
G. V. Volynets
Scientific Research Clinical Institute of Pediatrics and Pediatric Surgery named after Academician Yu.E. Veltishchev Federal State Autonomous Educational Institution of Russian National Research Medical University named after. N.I. Pirogov Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
A. I. Khavkin
Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region
Russian Federation
Russian Federation
References
1. Mavilia MG, Wu GY. HBV-HCV coinfection: viral interactions, management, and viral reactivation. J Clin Transl Hepatol. 2018;6(3):296-305. doi: 10.14218/JCTH.2018.00016.
2. Konstantinou D, Deutsch M. The spectrum of HBV/HCV coinfection: epidemiology, clinical characteristics, viralinteractions and management. Ann Gastroenterol. 2015;28(2):221-228.
3. Rodriguez-Iñigo E., Bartolomé J., Ortiz-Movilla N. et al. Hepatitis C virus (HCV) and hepatitis B virus (HBV) can coinfect the same hepatocyte in the liver of patients with chronic HCV and occult HBV infection. J Virol. 2005;79:15578-15581. doi: 10.1128/JVI.79.24.15578-15581.2005.
4. Pol S., Haour G., Fontaine H., Dorival C. et al. The negative impact of HBV/HCV coinfection on cirrhosis and its consequences. Aliment Pharmacol Ther. 2017;46(11-12):1054-1060. doi: 10.1111/apt.14352.
5. Sagnelli E, Sagnelli C, Macera M, Pisaturo M, Coppola N. An update on the treatment options for HBV/HCV coinfection. Expert Opin Pharmacother. 2017;18:1691-1702. doi: 10.1080/14656566.2017.1398233.
6. Liu S., Zhao K., Su X. et al. Enhanced host immune responses in presence of HCV facilitate HBV clearance in coinfection. Virol Sin. 2022;37(3):408-417. doi: 10.1016/j.virs.2022.04.001.
7. Cardoso C., Alves A.L., Augusto F. et al. Occult hepatitis B infection in Portuguese patients with chronic hepatitis C liver disease: prevalence and clinical significance. Eur J Gastroenterol Hepatol. 2013;25:142-146. doi: 10.1097/MEG.0b013e328359fe54.
8. Kannangai R., Vivekanandan P., Netski D. et al. Liver enzyme ares and occult hepatitis B in persons with chronic hepatitis C infection. J Clin Virol. 2007; 39:101-105. doi: 10.1016/j.jcv.2007.03.006.
9. Chen S.Y., Kao C.F., Chen C.M. et al. Mechanisms for inhibition of hepatitis B virus gene expression and replication by hepatitis C virus core protein. J Biol Chem. 2003;278(1):591-607. doi: 10.1074/jbc.M204241200.
10. Gordon S.C., Sherman K.E. Treatment of HBV/HCV coinfection: releasing the enemy within. Gastroenterology. 2009;136(2):393-396. doi: 10.1053/j.gastro.2008.12.017.
11. Marot A., Belaid A., Orlent H. et al. Characteristics of patients with hepatitis B virus and hepatitis C virus dual infection in a Western European country: Comparison with monoinfected patients. Clin Res Hepatol Gastroenterol. 2017;41(6):656-663. doi: 10.1016/j.clinre.2017.05.003
12. Abdelaal R., Yanny B., El Kabany M. HBV/HCV Coinfection in the Era of HCV-DAAs. Clin Liver Dis. 2019;23(3):463-472. doi: 10.1016/j.cld.2019.04.003.
13. Balagopal A., Thio C.L. Editorial Commentary: Another Call to Cure Hepatitis B. Clin Infect Dis. 2015;61(8):1307-9. doi: 10.1093/cid/civ475.
14. Heim M.H., Thimme R. Innate and adaptive immune responses in HCV infections. Hepatol. 2014;61(1 Suppl):S14-25. doi: 10.1016/j.jhep.2014.06.035.
15. Murai K., Hikita H., Kai Y. et al. Hepatitis C virus infection suppresses hepatitis B virus replication via the RIG-I-like helicase pathway. Sci Rep. 2020;10(1):941. doi: 10.1038/s41598-020-57603-9.
16. Chen L.W., Chien R.N., Yen C.L., Chang J.J., Liu C.J., Lin C.L. Therapeutic effects of pegylated interferon plus ribavirin in chronic hepatitis C patients with occult hepatitis B virus dual infection. J Gastroenterol Hepatol. 2010;25(2):259-63. doi: 10.1111/j.1440-1746.2009.06006.x.
17. Hiraga N., Imamura M., Hatakeyama T. et al. Absence of viral interference and different susceptibility to interferon between hepatitis B virus and hepatitis C virus in human hepatocyte chimeric mice. J Hepatol. 2009;51(6):1046-54. doi: 10.1016/j.jhep.2009.09.002.
18. Tamori A., Abiru S., Enomoto H. et al. Low incidence of hepatitis B virus reactivation and subsequent hepatitis in patients with chronic hepatitis C receiving directacting antiviral therapy. J Viral Hepat. 2018;25(5):608-611. doi: 10.1111/jvh.12840.
19. Eyre N.S., Phillips R.J., Bowden S., Yip E., Dewar B., Locarnini S.A., Beard M.R. Hepatitis B virus and hepatitis C virus interaction in Huh-7 cells. J Hepatol. 2009;51(3):446-57. doi: 10.1016/j.jhep.2009.04.025.
20. Pan Y., Wei W., Kang L. et al. NS5A protein of HCV enhances HBV replication and resistance to interferon response. Biochem Biophys Res Commun. 2007; 359:70-75. doi: 10.1016/j.bbrc.2007.05.052.
21. Schüttler C.G., Fiedler N., Schmidt K., Repp R., Gerlich W.H., Schaefer S. Suppression of hepatitis B virus enhancer 1 and 2 by hepatitis C virus core protein. J Hepatol. 2002;37:855-862. doi: 10.1016/S0168-8278(02)00296-9.
22. Pokorska-Spiewak M., Kowalik-Miko1ajewska B., Aniszewska M., Walewska- Zielecka B, Marczynska M. The in uence of hepatitis B and C virus coinfection on liver histopathology in children. Eur J Pediatr. 2015;174:345-353. doi: 10. 1007/s00431-014-2402-7.
23. Gish R.G. HBV/HCV Coinfection and Possible Reactivation of HBV Following DAA Use. Gastroenterol Hepatol (N Y). 2017;13(5):292-295.
24. Roy A., De A., Singh V. DAAs and HBV/HCV coinfection: glimmer of light and a few shades of grey. J Hepatol. 2020;73(2):461. doi: 10.1016/j.jhep.2020.03.010.
25. Bessone F., Dirchwolf M. Management of hepatitis B reactivation in immunosuppressed patients: An update on current recommendations. World J Hepatol. 2016;8(8):385-94. doi: 10.4254/wjh.v8.i8.38.
26. Terrault N.A., Bzowej N.H., Chang K.M., Hwang J.P., Jonas M.M., Murad M.H.; American Association for the Study of Liver Diseases. AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2016;63(1):261-83. doi: 10.1002/hep.28156.
27. Butt A.A., Yan P., Shaikh O.S., Abou-Samra A.B. Hepatitis B reactivation and outcomes in persons treated with directly acting antiviral agents against hepatitis C virus: results from ERCHIVES. Aliment Pharmacol Ther. 2018;47(3):412-420. doi: 10.1111/apt.14426.
28. Liu C.J., Chuang W.L., Sheen I.S. et al. Efficacy of ledipasvir and sofosbuvir treatment of HCV infection in patients coinfected with HBV. Gastroenterology. 2018;154(4):989-997. doi: 10.1053/j.gastro.2017.11.011.
29. Yanny B.T., Latt N.L., Saab S., Han S., Choi G., Kramer J., Sahota A.K. Risk of hepatitis B virus reactivation among patients treated with ledipasvir-sofosbuvir for hepatitis C virus infection. J Clin Gastroenterol. 2018;52(10):908-912. doi: 10.1097/MCG.0000000000000986.
30. Jamma S., Hussain G., Lau D.T. Current Concepts of HBV/HCV Coinfection: Coexistence, but Not Necessarily in Harmony. Curr Hepat Rep. 2010;9(4):260-269. doi: 10.1007/s11901-010-0060-4.
31. Terrault N.A., Lok A.S.F., McMahon B.J. et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560-1599. doi: 10.1002/hep.29800.
32. Yan L.B., Rao H.Y., Ma Y.J., Bai L., Chen E.Q., Du L.Y., Yang R.F., Wei L., Tang H.; CCgenos Study Group. 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. BMJ Open. 2016;6(10):e012016. doi: 10.1136/bmjopen-2016-012016.
33. Yang W.T., Wu L.W., Tseng T.C. et al. Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C Infection. Medicine (Baltimore). 2016;95(10):e2995. doi: 10.1097/MD.0000000000002995.
34. Squadrito G., Cacciola I., Alibrandi A., Pollicino T., Raimondo G. Impact of occult hepatitis B virus infection on the outcome of chronic hepatitis C. J Hepatol. 2013;59(4):696-700. doi: 10.1016/j.jhep.2013.05.043.
35. European Association for the Study of the Liver; European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370-398. doi: 10.1016/j.jhep.2017.03.021.
Review
For citations:
Volynets G.V., Khavkin A.I. Co-infection with hepatitis B and C viruses: current state of the problem. Experimental and Clinical Gastroenterology. 2024;(1):67-74. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-221-1-67-74
Views:
159
Email this article 