A co-infection with hepatitis B (HBV) virus and hepatitis C (HCV) virus is not anyway a rare disease. Acute hepatitis caused by HBV and HCV co-infection occurs in about 5% cases, predominantly in IV drug addicts, and it can reach 15-20% in chronic hepatitis.
It is impossible to find out retrospectively in older cases of chronic hepatitis, whether hepatitis experienced originated as a co-infection with both viruses or the super-infection with HBV or HCV occurred in the next course, but it is unsubstantial for antiviral treatment indication. Elderly patients with chronic hepatitis B and C over 60 years old belong among a little studied population which is generally excluded from the trials with antiviral treatment.
Such patients however exist though they are rather sporadic cases. Elderly patients are not anymore suitable for liver transplantation and surprisingly the antiviral treatment of HBV and HCV co-infection is not unambiguously defined even in the literature.
The article is a contribution to the possible treatment of some patients with chronic HBV and HCV infection and presents three typical patient case reports with a proposition of antiviral treatment