Angela Smith saw the effects
of liver damage when her mother, an alcoholic, died of
cirrhosis three years ago. Since then she hasn't touched
a drop of alcohol. Ironically, Angela is now suffering
a double dose of liver damage due to hepatitis B and C
infections at the age of 28. A study published in the
June issue of the Journal of Medical Virology shows
that Angela's case isn't that uncommon. The hepatitis
B virus (HBV) can persist in the liver of those with a
hepatitis C infection. Worse yet, there may be no detectable
HBV DNA in patients' serum, allowing the sneaky virus
to wreak havoc unnoticed.
The study was done by a team of
Spanish researchers headed by Dr Vicente Carreno of
the Fundación para el Estudio de las Hepatitis
Virales in Madrid. Dr Carreno and his colleagues checked
the serum of 98 patients for HBV DNA using the tremendous
power of the polymerase chain reaction (PCR), which
can replicate a huge amount of the target DNA, making
detection much easier. The researchers then took liver
biopsies to pinpoint the location of the hepatitis B
genetic material.
The results showed that HBV DNA
was present in the livers of 25 of 98 patients who had
chronic hepatitis C infections and who did not have
HBV DNA in their serum as determined by PCR.
There were no apparent clinical
differences in patients who did or did not have hepatitis
B lurking in their liver. Nonetheless, patients who
had a hepatitis C infection for less than 20 years and
who also had hepatitis B displayed more liver damage
than patients who did not have the HBV hitchhiker. "Since
... the presence of [hepatitis B] DNA in the liver accelerates
the progression of the histological damage in patients
with chronic [hepatitis C] infection, it seems reasonable
to consider vaccination against [hepatitis B virus]
infection in patients with chronic hepatitis C," Dr
Carreno told Reuters Health.
The research also points to the
possibility that hepatitis B infection levels may be
higher than was thought. Until now, the lack of a hepatitis
B marker in the serum was taken as evidence of the absence
of the virus but Dr Carreno's research shows that this
isn't always the case.
How HBV shows up in the liver but
not in the serum is still a mystery. Dr Carreno and
his colleagues are studying the relatives of patients
with concomitant HBV and hepatitis C infections to investigate
any family connection, such as the presence of a mutant
virus.
There's no vaccine for hepatitis
C at the moment, but one is available for hepatitis
B. Given these results, it might be wise to vaccinate
hepatitis C patients to protect against hepatitis B
infections.
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