Wilson's disease with hepatitis B infection: Occurrence, clinical presentation, and prognosis

Although Taiwan is an endemic area of hepatitis B with a prevalence rate of 15-20% for carriers in general population, the occurrence of this viral infection in patients with Wilson's disease (WD) and their clinical manifestations have not been reported. In this retrospective study, review of the medical records of patients with WD revealed 61 patients who had tests for HBsAg and HBsAB. In 10 HBsAg-positive patients(16%), the age of disease onset was 15.3±9.2 years; initial presentation was hepatic in 8; hepatic encephalopathy (HE) occurred in 8; and death from hepatic causes occurred in 5 within 2.4 ± 1.5 years after disease onset. On the other hand, 51 HBsAg- negative patients had onset age of 18.5±7.1 years, initial hepatic presentation in 15, HE in 4, and hepatic causes of death in 12 within 5.7±3.1 years. None of the patients, HBsAg positive or negative, had primary hepatocellular carcinoma. The present data suggest that the occurrence of hepatitis B infection in WD is not different from that of general population, but may aggravate the clinical course of WD.