الفهرس 
INTRODUCTION
LITERATURE REVIEWOnly 14 pages are availabe for public view
 |  | from | 188 |  |  |
| | | from | 188 | | |
Abstract
OBI is a world-wide diffused entity, although its distribution may reflect the
general prevalence of the HBV in the various geographic areas and in the various
populations. Although the presence of occult hepatitis B in chronic HCV infection is well
established, the clinical relevance is still being assessed. The impact of occult HBV coinfection
on anti-HCV therapy response also remains controversial. Several studies
focusing on anti-HCV treatment by IFN mono-therapy have suggested that occult HBV
was associated with poor IFN responses in HCV chronic patients. However, its impact on
the response of combination therapy remains poorly explored.
The aim of this work was to assess the prevalence of OBI in the serum of patients
with CHCV, and to evaluate its impact on the response to treatment with a combination of
Peg-IFNα and RBV.
Fifty chronic HCV infected patients who were treated with 180μg Peg–IFN α-2a or
1.5μg/kg Peg–IFN α-2b once a week in combination with RBV (800-1400 mg/day) for 48
weeks were included in this study. Patients were divided into two groups, group 1 which
included 25 patients of SVR and group 2 that included 25 patients of Non-SVR. Both
patient groups were subjected to detailed questionnaire, clinical examination and the
following laboratory investigations; biochemical studies (ALT, AST and Bilirubin)
heamatological studies (prothrombin activity and platelets count) and virological studies
that included the serological detection anti-HBc, anti-HBe, anti-HBs and anti-HCV
antibodies using ELISA technique and the detection of HBV-DNA (s & c genes) by SYBR
Green technique, pol gene by nested PCR and quantitative detection of HBV-DNA and
HCV viral load by TaqMan probe (Artus) technique.
Seventeen (34%) of our HCV patients were positive for OBI, 52.9% out of them
showed hepatomegaly, splenomegaly or hepatosplenomegaly. On the other hand, 57.6% of
the HCV patients negative for HBV-DNA had the same clinical picture suggesting that the
clinical findings were more asso ıG ˇ ±ıııG•ıGtion. 51.1% and 54.5% of our HCV
patients negative for HBV-DNA had elevated ALT and AST respectively while HCV
patients with occult HBV had a lower percentage of ALT (41.1%) and AST (35.3%)
abnormal values. 82.4% of our HBV-DNA positive patients were associated with high
HCV viral load compared to 39.4% of HBV-DNA negative and this was statistically
significant. 11 (22%) of the 50 HCV patients were anti-HBc positive of whom 10 (90.9%)
were HBV-DNA positive, on the other hand 39 (78%) were anti-HBc negative of whom
only 7 (17.9%) were positive for HBV-DNA. Only 6 (12%) of the 50 HCV patients were
anti-HBs positive. Four (66.6%) of them were HBV-DNA positive. In the present study,
SVR was achieved in 60.6% of the HBV-DNA negative chronic HCV patients compared
to only 29.4% of the occult HBV chronic HCV patients. This was statistically significant.
Out of the 11 anti-HBc positive 9 (81.8%) were associated with Non-SVR HCV patients,
while 30 (81.08%) out of 37 sero-negative CHCV patients were HBV-DNA negative.
Among our 11 sero-positive CHCV patients 7 were anti-HBc positive, anti-HBs negative
of whom 6 (85.7%) were HBV-DNA positive.
Summary & Conclusion
-121 -
In conclusion OBI was a prominent feature among CHCV patients (34%). OBI was
significantly associated with poor response to combined Peg-IFN α & RBV therapy. Since
48% of the Non-SVR patients were HBV-DNA positive compared to 20% of SVR
patients.
The anti-HBc positivity was detected in 22% of CHCV patients. Anti-HBc
positivity was significantly associated with poor response to combined Peg-IFN α & RBV
therapy. Since 36% of the Non-SVR patients were anti-HBc positive compared to 8% of
SVR patients