This multi-center study was designed as a trial to explore the prevalence of silent hepatitis B infection among hepatitis C patients and to determine the prevalent genotype of hepatitis C virus (HCV) in these patients. The study comprised 45 patients with post-hepatitic liver cirrhosis. All patients gave blood samples for estimation of liver function tests and ELISA estimation of serum levels of hepatitis B surface antigen (HBsAg) and anti-HCV antibodies; patients with HbsAg positive were excluded off the study. Qualitative detection of HCV RNA and HBV DNA by PCR (home-made PCR) and quantitative PCR for estimation of HCV viremia and HCV genotyping by REFLP technique were performed. The HCV-Ab was detected in all samples irrespective of its clinical severity class with a mean viremia level of792336.7±400074.8; range: 134985-1957632 viral copy/ml as determined by quantitative PCR with a non-significant difference between severity clinical classes as regards viremia level. The HBV DNA was detected using qualitative PCR in 20 samples (44.4%); 4 class A, 7 class B and 9 class C samples with a significant increase of the frequency of silent HB in patients with class B (X2=5.446, p<0.01) and C (X2S.154, p<0.00l) in comparison to class A patients. Genotyping of HCV reported 41 samples (91.1%) with genotype-4 and 4 samples (8.9%) with genotype-1 with a prevalence rate of HCV genotype-4 was 91.1%. There was positive non-significant correlation between both HCV genotype and the presence of silent hepatitis B infection and clinical severity, however, using the receiver operating characteristic (ROC) curve analysis judged by the area under the curve (AUC) to evaluate the sensitivity and specificity of detection of silent hepatitis B infection and identification of HCV genotype as predictors of severe hepatitis showed a non-specific role for genotyping for prediction of severity with AUC=0.467, while the detection of HBV DNA using PCR in patients with HCV infection is a specific predictor of severity with AUC=0.617. It could be concluded that HCV genotype-4 is the most prevalent type in Egyptian Hepatitis C cirrhotic patients with a prevalence of silent hepatitis B of 44.4% and its detection is a specific predictor of severe cirrhosis.
Key Word: Hepatitis - PCR – Genotype |
