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Triple hepatitis: frequency and treatment outcome of co/super- infection of hepatitis C and D among patients of hepatitis B
Author(s):
1. Bader Faiyaz Zuberi: Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
2. Salahuddin Afsar: Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
3. Muhammad Saeed Quraishy: Department of Surgery , Dow University of Health Sciences, Karachi, Pakistan
Abstract:
Objective: To determine the frequency of hepatitis C and D in patients of chronic hepatitis B and the treatment response of hepatitis B in such patients. Study Design: Case series. Place and Duration of Study: Civil Hospital and Lyari General Hospital, Dow University of Health Sciences, from July 2003 to June 2005. Patients and Methods: All patients of hepatitis B presenting during the study period were screened for triple infection by carrying out anti-HBc (IgG), anti-HCV and anti-HDV. Patients who were positive to all three were included in the study. Complete Blood Count (CBC); HBsAg; HBeAg; anti-HBc IgM; anti-HDV; anti-HCV; HBV DNA PCR; HCV RNA PCR; serum albumin; SGPT; serum bilirubin and ultrasound abdomen were acquired in all patients. All patients received pegylated interferon-a 2a 180 mcg sc weekly x 48 weeks. Patients who were also positive for HCV RNA also received ribavirin 10001200 mg/d po x 24 weeks for genotype 3 and 48 weeks for genotype 1. Descriptive statistics were used for describing the data. Results: Out of the 246 patients of HBV, 29 (11.8%) patients were also positive for anti-HBc IgG, anti-HDV and anti-HCV. After 48 weeks of therapy, the respective viral undetection by PCR was 4 (13.8%) in patients having only HBV DNA, 3 (10.3%) in patients with only HCV RNA and in patients who had both HBV DNA and HCV RNA positive, simultaneously HCV was cleared in 2 (6.9%) while HBV was not cleared in any case. Conclusion: In patients coming with one hepatic infection, other infections should be sought as they share a common mode of spread and may affect the overall response to treatment.
Page(s): 404-407
DOI: DOI not available
Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 18, Issue: 7, Year: 2008
Keywords:
Chronic hepatitis Triple hepatitis Pegylated interferon Hepatitis B virus Hepatitis C virus Hepatitis D virus
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