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CORRESPONDENCE
Year : 2004  |  Volume : 22  |  Issue : 4  |  Page : 269-270
 

Study of Hepatitis B and C viral markers in patients of chronic liver disease


Departments of Microbiology, PGIMER, Chandigarh - 160 012, India

Date of Submission15-Mar-2004
Date of Acceptance17-Apr-2004

Correspondence Address:
Departments of Microbiology, PGIMER, Chandigarh - 160 012, India



How to cite this article:
Singh V, Katyal R, Kochhar R K, Bhasin D K, Aggarwal R P. Study of Hepatitis B and C viral markers in patients of chronic liver disease. Indian J Med Microbiol 2004;22:269-70


How to cite this URL:
Singh V, Katyal R, Kochhar R K, Bhasin D K, Aggarwal R P. Study of Hepatitis B and C viral markers in patients of chronic liver disease. Indian J Med Microbiol [serial online] 2004 [cited 2019 Oct 18];22:269-70. Available from: http://www.ijmm.org/text.asp?2004/22/4/269/12824


Dear Editor,
Hepatitis B and C Viruses are known as main causative agents of chronic liver disease (CLD) throughout the world.[1] After the discovery of HCV in 1989, reports from India have shown a variable prevalence of this virus in cases of cryptogenic chronic liver disease and cirrhosis. The high prevalence rates of HCV co-infection have been detected world wide among patients with severe chronic hepatitis, cirrhosis and inactive HBV infection.[2] Studies from India have shown wide variation in prevalence of HCV in patients of chronic liver diseases.[3] The present study was planned to assess the relative incidence of HBV and HCV in patients with CLD.
One hundred patients (70 males, 30 females) with CLD, attending Gastroenterology clinic or admitted in our wards from May 1996 to January 1999, were studied. Age range was 16-75 years (Mean 46.5 yrs.). In 30 patients, a history of blood transfusion was recorded. Fifteen patients gave history of alcohol ingestion (> 40 gm per day for > 5 years). From each patient, 5mL blood sample was drawn and sera were frozen at -20C till tested by ELISA. Viral markers HBsAg, anti HBc IgM and anti HCV were detected by ELISA using commercial kits (General Biological). For detection of anti HCV, 3rd generation ELISA was used (General Biological).
Out of the 100 samples tested, 48 were positive for anti HCV antibodies and 30 for HBV markers. In 22 patients none of the above markers for HBV or HCV were detected. Six patients with HBV had concurrent HCV infection and of four out of these were carriers of HBV, (anti HBc IgM negative) superadded with HCV infection. Four patients were labelled as HBsAg carriers where anti HBc IgM and anti HCV were absent. HBV was more prevalent in patients below 40 years while prevalence for HCV was higher in patients above 40 years.
The present study shows a high prevalence of HCV in patients with CLD. Studies from southern Europe and the US have also shown a high percentage of HCV in patients with cirrhosis.[4] Studies from India have shown a lower prevalence of HCV (3-31.5%) in patients of cirrhosis and CLD.[3] Most of these studies have shown a lower prevalence of anti HCV in comparison to HBV. A study from New Delhi has shown HBV infection as the major cause of chronic liver disease.[5] We noticed a higher prevalence of HBV in patients below 40 years of age, while in patients above 40 years of age HCV infection was the major cause. Mean age of patients in the earlier study was 35.9 years,[5] while in our study it was 46.5 years. That may be one reason for higher prevalence of HCV in our study. In 6% cases HBV and HCV were present simultaneously as has been seen in other reports.[4],[5] Twenty- two patients in our study were labelled as cryptogenic where we could not detect HBV or HCV infection. Since we have tested a limited number of markers for above viruses and have not tested the presence of HCV RNA and HBV DNA, we might have missed few cases infected with either of these two viruses. It has been shown earlier that 7.3% cases of HBV were detected only on the basis of HBV DNA where all others markers for HBV were absent.[5] In 10 of 22 cases labelled as cryptogenic, there was a clear history of blood transfusion in past. Few more viruses (HGV) have been identified and characterised as the agents for post-transfusion hepatitis in human being. Chronic HGV infection appears to be without clinical significance. Persistant viraemia of HGV infection is frequent but is not related to CLD.
In conclusion, our study shows that HCV is the major cause for cirrhosis of liver followed by HBV. Higher prevalence of HCV in patients above 40 years shows a slow progression of disease with HCV in comparison to HBV. 

 ~ References Top

1.Esteban JI. Epidemiology of hepatitis C virus infection: A global perspective, In: Transfusion associated infections. SK Sarin, George H.Eds. (CBS publishers, New Delhi) 1998:67-77.  Back to cited text no. 1    
2.Tankhiwale SS, Khandase RK, Jalgaonkar SV. Seroprevalence of anti HCV and hepatitis B surface antigen in HIV infected patients. Indian J Med Microbiol 2003;21:268-270.  Back to cited text no. 2    
3.Aggarwal N, Naik S, Kini D, Somani SK, Singh H, Aggarwal R. HCV as a cause of liver cirrhosis: frequency and genotype distribution. Indian J Gastroenterol 2001; 20(Suppl. 2):A83.   Back to cited text no. 3    
4.Fattowich G, Tagger A, Brollo L, Guistina G, Pontisso P, Realdi G, Alberti A, Rulo A. Hepatitis C virus infection in chronic hepatitis B virus carriers. J Infect Dis 1991; 163:400-401.  Back to cited text no. 4    
5.Sarin SK, Guptan RC, Banerjee K, Khandekar P. Low prevalence of hepatitis C viral infection in patients with non alcoholic chronic liver disease in India. JAPI 1996;44:243-245.  Back to cited text no. 5    
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