There are conflicting data on the pathogenic effects of double infection with HBV and HCV, compared to infection with a single virus. Patients with dual infection may have a worse clinical presentation and a more rapidly evolving form of chronic liver disease (8,11,18,23-30). Aminotransferase levels are higher and liver disease more severe, both histo-logically and in the degree of clinical decompensation, in co-infected patients (18,28,30,31).
Contrasting views have been reported by others, who found no significant difference in the clinical and histologic presentation of HBV and HCV co-infected patients, compared to those with single infection. Furthermore, they described the liver injury in a majority of co-infected patients as only mild to moderate in severity, similar to those seen in patients infected with either HBV or HCV alone (20,25,32-34).
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