HCV, HBV coinfection increased risks for cirrhosis, carcinoma, death

SAN DIEGO — Patients who are infected with hepatitis C and hepatitis B are at significantly increased risks for cirrhosis, hepatocellular carcinomas and death, according to data presented at the 2012 Digestive Disease Week Annual Meeting.

Researchers evaluated data from 102,971 patients with HCV collected from the National Veterans Affairs HCV Clinical Case Registry. Patients in this cohort coinfected with HBV (n=1,431) were compared with mono-infected patients for incidences of cirrhosis, hepatocellular carcinomas (HCC) and mortality.

There were 2,271 incidences of cirrhosis per 100,000 person-years among coinfected patients compared with 1,808 in HCV mono-infected patients (P<.05). Incidences of death (4,093 vs. 3,364 per 100,000 person-years) and HCC (518 vs. 367 per 100,000 person-years) also were significantly higher among coinfected patients (P<.05 for both).

Using multivariable Cox proportional hazard models and adjusting for demographic and clinical confounders, investigators found that increased risk for cirrhosis (HR=1.32; 95% CI, 1.14-1.51), death (HR=1.24; 95% CI, 1.13-1.36) and HCC (HR=1.56; 95% CI, 1.19-2.05) were all independently associated with HBV coinfection compared with HCV mono-infection.

“If you have a patient with hepatitis C, it’s very important to know if they have hepatitis B as well, because their clinical outcomes could be worse,” researcher Gia L. Tyson, MD, Baylor College of Medicine, told Healio.com. “If patients are co-infected, it’s important to closely monitor them for these potential outcomes like cirrhosis or developing liver cancer, knowing they’ll probably do worse than their counterparts with hepatitis C alone.”

Tyson said an ongoing study will determine whether treating either HCV or HBV more aggressively in coinfected patients will improve the observed outcomes.

For more information:

Tyson GL. #Mo1901: Clinical Outcomes of Hepatitis B Co-Infection in a United States Cohort With Hepatitis C. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, San Diego.