April 22, 2013
Researchers reviewed data on patients with the hepatitis C virus (HCV) infection who had been tested for hepatitis B between 1997 and 2005 from the National Veterans Affairs HCV Clinical Case Registry. Data indicate that 168,239 individuals who were exposed to HCV were tested for HBV.
Patients were classified as HCV exposed if their records indicated two positive HCV tests or one test with a diagnostic code, and HCV infected if they showed HCV RNA or a genotype. Also, they were classified HBV exposed if they met certain conditions, such as a positive test for hepatitis B surface antigen (HBsAG), HBV DNA, or Hepatitis Be antigen (HBeAg) hepatitis B core or Be antibodies. If the patients had a positive HBsAG, HBV DNA, or HBeAG test within one year of HCV diagnosis, they were considered coinfected.
Of the 168,239 patients with HCV exposure, 34.7 percent had HBV exposure. There were 102,971 patients with HCV infection, and 1.4 percent of them were coinfected with HBV. Factors independently associated with HBV/HCV coinfection were age fifty years or younger; male sex; positive HIV status; history of hemophilia, sickle cell anemia, or thalassemia; history of blood transfusion; and cocaine or other drug use. According to researchers, Hispanics had a reduced risk for coinfection.
The researchers noted that this was the largest cohort study in the United States to determine the prevalence of coinfection in individuals with HCV. They commented that among veterans with HCV exposure to HBV is common, but HBV coinfection is low. They recommend that patients with HCV exposure be tested for HBV; also, the risk factors mentioned can be used to target screening and prevention programs for persons with the highest risk of coinfection.
The full report, "Prevalence and Predictors of Hepatitis B Virus Co-Infection in a United States Cohort of Hepatitis C Virus-Infected Patients," was published online ahead of print in the journal Hepatology, (2013; doi: 10.1002/hep.26400).