关键词: 乙型肝炎, 丙型肝炎, 重叠感染, 临床特点, 疾病转归

Abstract: Objective Due to the interference between two viruses,the clinical features and prognosis in patients with superinfection of hepatitis B virus and hepatitis C virus（HBV/HCV） are usually different from the patients with single hepatotropic virus infection. The aim of this study is to investigate the characteristics of the mutual interference between the viruses and disease outcomes in patients with HBV/HCV superinfection,and provide evidence to help the diagnosis and treatment for the HBV/HCV superinfection patients. Methods 30 patients with HBV/HCV superinfection were enrolled between November 2002 and December 2013 in the Third Hospital, Hebei Medical University,and 59 patients with chronic hepatitis B（CHB） and 54 patients with chronic hepatitis C（CHC） between June 2013 and December 2014 in the Third Hospital,Hebei Medical University were also included in this study. All the patients in each group were retrospectively analyzed for the patient's general conditions and clinical data. Results Serum level of globulin in patients in HBV/HCV superinfection was （32.12±6.76） g/L,significantly higher than that in CHB patients【（28.69±7.16） g/L, P<0.05】,serum level of ALT was（134.02±209.34） U/L,significantly higher than that in CHB group【（71.57±53.23）U/L,P<0.01】, serum level of total bilirubin was（62.18±99.05）μmol/L,which was significantly higher than that in CHB group【（30.98±30.70）μmol/L,P<0.01】, serum level of GGT was（71.60±51.92）U/L,which was significantly higher than that in CHB group【（50.28±47.23）U/L,P<0.05】,and the level of prothrobin time activity （PTA） was （73.39±17.19）%,which was significantly lower than that in CHB group 【（91.28±17.71）%,P<0.01】;the negative rate of serum HBeAg in HBV/HCV superinfection group was 50.0%,not significantly different（P>0.05） as compared to 45.0% in HBV infection group; the positive rate of serum HBV DNA in HBV/HCV superinfection group was 50.0%,which was significantly lower than that in HBV infection group（79.7%,P<0.01）;the serum viral load in HBV/HCV superinfection group was significantly lower than that in CHB group,and the difference was significant （Z=-3.331, P<0.01）;the incidence of severe chronic hepatitis and cirrhosis in HBV/HCV superinfection group was 53.3%,which was significantly higher than that in HBV infection group（34.0%,P<0.05）,and there was an significant difference in terms of disease outcome（Z=-3.121,P<0.01）;serum albumin level in patients with HBV/HCV superinfection was（37.78±6.74） g/L,which was significantly lower than that in CHC group【（43.07±4.48） g/L, P<0.01】,serum globulin level was significantly higher than that in CHC group【（28.83±5.84）g/L,P<0.05】,serum level of AST was significantly higher than that in CHC group【（51.29±38.61）U/L,P<0.05】,serum level of ALT was significantly higher than that in CHC group【（52.91±29.71） U/L,P<0.01】,serum bilirubin level was significantly higher than that in CHC group【（16.71±7.65）μmol/L,P<0.01】,serum level of GGT was significantly higher than that in CHC group【（38.39±29.10）U/L,P<0.01】 and PTA was significantly lower than that in CHC group【（104.62±16.10）%,P<0.01】;serum HCV RNA load in patients with HBV/HCV superinfection was significantly lower than that in CHC group（Z=-5.612,P<0.01）;the incidence of severe liver function damage in HBV/HCV superinfection group was 53.3%,which was higher than that in CHC group（13.0%,Z=-5.249,P<0.01）. Conclusions HBV/HCV superinfection tends to lead to more severe liver damage,and the incidence of liver cirrhosis is also significantly increased,while the serum viral loads might be lower,which needs to take into consideration in clinical practice.

Key words: Hepatitis B, Hepatitis C, Superinfection, Clinical feature, Disease outcomes