Analysis Of Serological Characteristics And Infections In Patients With HCV/HBV Co-infection

[Objective]:To find out the prevalence of co-infection with hepatitis B virus(HBV)among hepatitis C virus(HCV)patients in our hospital.The prevalence of different HBV-related serological markers in HCV-infected patients,as well as the relationship between the two viral loads in patients who have both HBV and HCV co-infection(HCV/HBV co-infection)and their effects on clinical outcome.[Methods]:Firstly,we recorded 10405 HCV patients who visited our hospital between January 1,2010,and December 31,2020.Then,we selected 8652 patients who had complete HBVM data and were anti-HCV positive.We collected and examined the fundamental data,the severity of the liver disease,and the virological information.Furthermore,we selected 505 HCV/HBV co-infection patients who had complete inpatient records without antiviral treatment and collected the following information:past medical history,personal history,and serological parameters.Finally,we analyzed the correlation relationship and serological characteristics of HCV and HBV viral load and explored the serological characteristics of chronic hepatitis,cirrhosis,and liver cancer in these patients.[Results]:The results of part Ⅰ:(1)The rate of HCV/HBV co-infection(Anti-HCV positive and HBsAg positive and(or HBV DNA positive)was 5.84%(505/8652)and the previous HBV infection(HBsAg negative and anti-HBc positive)was 48.19%(4169/8652);the rate of anti-HBs positive patients was 14.64%(1267/8652)and the susceptible HBV infection was 31.33%(2711/8652).(2)According to age,we divided patients into four groups:0-17 years old,18years old,45-59 years old,and over 60 years old.The trend of HCV/HBV co-infection patients and the previous HBV infection patients rises with age,whereas the trend of the anti-HBs positive patients falls and the trend of the susceptible HBV infection patients remains constant with birth year.(3)According to the birth year,we divided patients into three groups:before 1992,1992-2005,and after 2005.It was found that the rate of HCV/HBV co-infected patients and the previous HBV infected patients both dropped with the birth year,and the rate of anti-HBs positive patients increased with the birth year.The susceptible HBV infection patients showed no obvious trend.The results of part Ⅱ:(1)The HBV DNA and HCV RNA load level were analyzed by Spearman rank correlation(rs=0.35,p<0.001).(2)There were four groups for the viral load,BLCL group(HBV DNA<103IU/ml and HCV RNA<104IU/ml group),BLCH group(HBV DNA≤103IU/ml and HCV RNA>104IU/ml group),BHCL group(HBV DNA>103IU/ml and HCV RNA≤104IU/ml group),BHCH group(HBV DNA>103IU/ml and HCV RNA>104IU/ml group).The results indicated that there were significant differences in the four groups in PLT,ALT,AST,TBIL,DBIL,ALB,PTa,PT,FIB-4,and APRI(p<0.05).Compared to the other three groups,the BHCH group had better lab results in PLT,AST,TBIL,DBIL,ALB,PTa,PT,FIB-4,and APRI and poorer results in PLT,TBIL,DBIL,ALB,PTa,PT,and FIB-4 as well as a shorter time in HBV infection.the BHCL group had poorer lab results in PLT,AST,TBIL,DBIL,ALB,PT a,PT,FIB-4,and APRI.[Conclusion]:(1)The rate of HCV/HBV co-infected patients and the previous HBV infected patients has considerably dropped since China’s hepatitis B immunization program come into effect.(2)A large number of HCV patients still lack HBV protective immunity.(3)Mutual resistance between the two viruses is suggested by the negative association between HBV DNA and HCV RNA load level in HCV/HBV co-infected patients.(4)The rate of HCV replication was highest(46.85%)and the rate of HCV and HBV replication both activity was lowest(6.30%)in the HCV/HBV co-infected patient without antiviral treatment.The patients with predominant HBV viral replication showed more severe liver damage,lower PLT,ALB,PTa,FIB-4,and APRI index values,and higher FIB-4 and APRI index values.