{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:07:07Z","timestamp":1788944827372,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hepatitis B (HBV) and hepatitis C (HCV) coinfection leads to the progression of liver disease and results in clinically serious outcomes. Continuous monitoring of epidemiological data is crucial for managing the regional disease burden. This study investigates the current seroprevalence of HBV and HCV, the prevalence of coinfection, and the rates of active replication in Istanbul. Methods: This retrospective analysis included 7131 patients evaluated at the Infectious Diseases and Gastroenterohepatology clinics between 2021 and 2025. Initial serological screening for viral markers was performed using routine chemiluminescent immunoassays. Active viral replication was subsequently confirmed and quantified via real-time polymerase chain reaction (PCR). Results: Active HBV replication was significantly more frequent among patients in the Gastroenterohepatology clinic (20.47%) compared to those in Infectious Diseases (5.36%). Active HCV infections were rare in both departments (0.25% and 0.04%, respectively). Simultaneous HBV and HCV coinfection was detected in only 17 patients (0.24%). Demographic evaluation demonstrated that HBV marker positivity was more prevalent in male patients and individuals over 40 years of age. Conclusions: HBV seroprevalence remains substantially higher than HCV in this cohort. The high rate of active HBV replication in gastroenterohepatology settings indicates a concentrated burden of active disease in these specialized clinics. These distribution patterns emphasize the necessity of routine, targeted HBV screening for older male demographics to facilitate early clinical intervention.<\/jats:p>","DOI":"10.3390\/diagnostics16182895","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:05:43Z","timestamp":1788941143000},"page":"2895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Seroepidemiological Prevalence of Hepatitis B and C Virus Coinfection: A Large-Scale Retrospective Cohort Study in Istanbul"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0592-7297","authenticated-orcid":false,"given":"Arat","family":"Hulikyan","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"},{"name":"Department of Medical Microbiology, Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2476-3796","authenticated-orcid":false,"given":"Hayriye Kirkoyun","family":"Uysal","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3554-4879","authenticated-orcid":false,"given":"Gizem","family":"Dagci","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2203-4255","authenticated-orcid":false,"given":"Bilger","family":"Cavus","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4910-249X","authenticated-orcid":false,"given":"Sebahattin","family":"Kaymakoglu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9969-4061","authenticated-orcid":false,"given":"Murat Hakan","family":"Kir","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-8199","authenticated-orcid":false,"given":"Arif Atahan","family":"Cagatay","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0526-6759","authenticated-orcid":false,"given":"Derya Sevimli","family":"Saydan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"},{"name":"Department of Medical Microbiology, Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9670-2426","authenticated-orcid":false,"given":"Mehmet","family":"Demirci","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, K\u0131rklareli University, K\u0131rklareli 39100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5470-296X","authenticated-orcid":false,"given":"Ali","family":"Agacfidan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3987-6611","authenticated-orcid":false,"given":"Mustafa","family":"Onel","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34452, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4103\/jgid.jgid_219_24","article-title":"The State of the Globe: The Global Challenge of Hepatitis B and C Coinfection","volume":"16","author":"Thakur","year":"2024","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_2","unstructured":"World Health Organization (2026, August 12). Cancer. Available online: https:\/\/who.int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e70121","DOI":"10.1002\/mco2.70121","article-title":"The Malignant Transformation of Viral Hepatitis to Hepatocellular Carcinoma: Mechanisms and Interventions","volume":"6","author":"Yuan","year":"2025","journal-title":"MedComm (2020)"},{"key":"ref_4","first-page":"1784","article-title":"Progress and prospects of elastography techniques in the evaluation of fibrosis in chronic liver disease","volume":"20","author":"Wang","year":"2024","journal-title":"Arch. Med. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"(2024). Viral hepatitis elimination-time to act. Nat. Rev. Gastroenterol. Hepatol., 21, 529.","DOI":"10.1038\/s41575-024-00963-8"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"a021410","DOI":"10.1101\/cshperspect.a021410","article-title":"Hepatitis B virus epidemiology","volume":"5","author":"MacLachlan","year":"2015","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s12072-018-9863-0","article-title":"Prevention of mother-to-child transmission: The key of hepatitis B virus elimination","volume":"12","author":"Lin","year":"2018","journal-title":"Hepatol. Int."},{"key":"ref_8","first-page":"493","article-title":"Ten year hepatitis A, B, and C seroprevalence trend in children: Results from a single center","volume":"4","author":"Narsat","year":"2022","journal-title":"Med. Rec."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"768","DOI":"10.26719\/emhj.22.071","article-title":"15-year evaluation of changes in the HBsAg positivity rate in pregnant women in Turkey: The prominent effect of national vaccination","volume":"28","author":"Tosun","year":"2022","journal-title":"East. Mediterr. Health J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/liv.14862","article-title":"Is elimination of HCV realistic by 2030: France","volume":"41","author":"Pol","year":"2021","journal-title":"Liver Int."},{"key":"ref_11","first-page":"652","article-title":"Seroprevalence of hepatitis B and C among oncology patients in Turkey","volume":"29","year":"2012","journal-title":"J. Health Popul. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4274\/vhd.92063","article-title":"An unusual extrahepatic manifestation of acute hepatitis B infection: Epididymitis","volume":"20","author":"Kehribar","year":"2014","journal-title":"Viral Hepatit Derg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"871401","DOI":"10.1155\/2012\/871401","article-title":"Extrahepatic manifestations and autoantibodies in patients with hepatitis C virus infection","volume":"2012","author":"Himoto","year":"2012","journal-title":"Clin. Dev. Immunol."},{"key":"ref_14","first-page":"740138","article-title":"Morphologic features of extrahepatic manifestations of hepatitis C virus infection","volume":"2012","author":"Zhu","year":"2012","journal-title":"Clin. Dev. Immunol."},{"key":"ref_15","first-page":"258","article-title":"Investigating the epidemiological characteristics and risk factors of hepatitis B and C infections in the high-risk population of the cities covered by Jiroft University of Medical Sciences during the years 2014-2023: A descriptive study","volume":"24","author":"Hushmandi","year":"2025","journal-title":"J. Rafsanjan Univ. Med. Sci."},{"key":"ref_16","first-page":"e85985","article-title":"Prevalence and Risk Factors of Hepatocellular Carcinoma in Patients Co-infected With Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV): A Cross-Sectional Retrospective Study","volume":"17","author":"Iqbal","year":"2025","journal-title":"Cureus"},{"key":"ref_17","first-page":"68","article-title":"Research progress on hepatitis B combined with C and its treatment","volume":"32","author":"Lin","year":"2024","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1007\/s11901-010-0060-4","article-title":"Current concepts of HBV\/HCV coinfection: Coexistence, but not necessarily in harmony","volume":"9","author":"Jamma","year":"2010","journal-title":"Curr. Hepatol. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Shahriar, S., Araf, Y., Ahmad, R., Kattel, P., Sah, G.S., Rahaman, T.I., Sadiea, R.Z., Sultana, S., Islam, S., and Zheng, C. (2022). Insights into the coinfections of human immunodeficiency virus\u2013hepatitis B virus, human immunodeficiency virus\u2013hepatitis C virus, and hepatitis B virus\u2013hepatitis C virus: Prevalence, risk factors, pathogenesis, diagnosis, and treatment. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.780887"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"296","DOI":"10.14218\/JCTH.2018.00016","article-title":"HBV-HCV Coinfection: Viral Interactions, Management, and Viral Reactivation","volume":"6","author":"Mavilia","year":"2018","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Anvari, H.Z., Binabaj, M.M., Asadi, A., Abdi, M., Shakiba, A., Heidary, M., and Sholeh, M. (2023). Epidemiology of HBV-HCV Coinfection Among Iranian Patients: A Systematic Review and Meta-Analysis 10.7754\/Clin.Lab.2023.230503. Clin. Lab., 69.","DOI":"10.7754\/Clin.Lab.2023.230503"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Tseng, C.W., Liu, W.C., Chen, C.Y., Chang, T.T., and Tseng, K.C. (2022). Impact of HCV viremia on HBV biomarkers in patients coinfected with HBV and HCV. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07326-1"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Badshah, Y., Shabbir, M., Khan, K., Zafar, S., Afsar, T., Husain, F.M., Amor, H., and Razak, S. (2025). HCV and HBV genotypes: Vital in the progression of HCV\/HBV co-infection. BMC Gastroenterol., 25.","DOI":"10.1186\/s12876-025-03587-7"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.ajg.2022.06.006","article-title":"Seroprevalence of HBV\/HCV coinfection among patients with HCV screened during the national campaign for HCV eradication in Egypt","volume":"23","author":"Hassany","year":"2022","journal-title":"Arab. J. Gastroenterol."},{"key":"ref_25","first-page":"34","article-title":"Bir \u00dcniversite Hastanesi Aile Hekimli\u011fi Poliklini\u011fine Ba\u015fvuran Bireylerde Ya\u015f Gruplar\u0131na G\u00f6re Viral Hepatit Seroprevalans\u0131","volume":"12","author":"Adahan","year":"2020","journal-title":"Konuralp Med. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3205","DOI":"10.1172\/JCI135616","article-title":"Diminished hepatic IFN response following HCV clearance triggers HBV reactivation in coinfection","volume":"130","author":"Cheng","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Shih, Y.F., and Liu, C.J. (2020). Hepatitis C Virus and Hepatitis B Virus Co-Infection. Viruses, 12.","DOI":"10.3390\/v12070741"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7201a1","article-title":"Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations\u2014United States, 2023","volume":"72","author":"Conners","year":"2023","journal-title":"MMWR. Recomm. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Kenfack-Momo, R., Kenmoe, S., Takuissu, G.R., Ebogo-Belobo, J.T., Kengne-Nd\u00e9, C., Mbaga, D.S., Tchatchouang, S., Oyono, M.G., Kenfack-Zanguim, J., and Fogang, R.L. (2022). Epidemiology of hepatitis B virus and\/or hepatitis C virus infections among people living with human immunodeficiency virus in Africa: A systematic review and meta-analysis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0269250"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"8554","DOI":"10.1038\/s41598-021-87975-5","article-title":"Changing epidemiology and viral interplay of hepatitis B, C and D among injecting drug user-dominant prisoners in Taiwan","volume":"11","author":"Lu","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s44197-025-00508-5","article-title":"The Prevalence and Risk Factors of Hepatitis B, Hepatitis C, and Hepatitis D Coinfection in Iran\u2019s General Population Over the Past 25 Years: A Systematic Review and Meta-Analysis","volume":"16","author":"Naderi","year":"2025","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s40249-021-00876-7","article-title":"The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: A systematic review and meta-analysis","volume":"10","author":"Fararouei","year":"2021","journal-title":"Infect. Dis. Poverty"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"US Preventive Services Task Force, Owens, D.K., Davidson, K.W., Krist, A.H., Barry, M.J., Cabana, M., Caughey, A.B., Donahue, K., Doubeni, C.A., and Epling, J.W. (2020). Screening for Hepatitis C Virus Infection in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement. JAMA, 323, 970\u2013975.","DOI":"10.1001\/jama.2020.1123"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e70092","DOI":"10.1111\/jvh.70092","article-title":"HBV Dominance Is Associated With a Distinct Inflammatory Milieu in HBV\/HCV Coinfection","volume":"32","author":"Oltmanns","year":"2025","journal-title":"J. Viral Hepat."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Park, Y.J., Yi, K.Y., Woo, H.Y., Heo, J., and Song, G.A. (2025). Risk of HBV reactivation in HBV\/HCV-co-infected HCV-treated patients: A single-center study. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0324019"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/hiv.13372","article-title":"HBV, HCV, or syphilis coinfection with HIV in pregnant women seen at the main hospital in the capital of Venezuela","volume":"24","author":"Nobrega","year":"2023","journal-title":"HIV Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Eleje, G.U., Onubogu, C.U., Igbodike, E.P., and Firdous, S.M. (2025). Editorial: HIV\/HBV and\/or HCV infections and hepatotoxicity in pregnant and non-pregnant women. Front. Reprod. Health, 7.","DOI":"10.3389\/frph.2025.1538380"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e70061","DOI":"10.1111\/jvh.70061","article-title":"Clinical Observational Study on HBV Reactivation After Direct-Acting Antiviral Therapy in HCV\/HBV Coinfected Patients in Guizhou, China","volume":"32","author":"Wang","year":"2025","journal-title":"J. Viral Hepat."},{"key":"ref_39","first-page":"997","article-title":"Mechanism and clinical significance of HBV reactivation after anti-HCV therapy","volume":"30","author":"Zeng","year":"2022","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Colombatto, P., Palmisano, E., Ricco, G., Cavallone, D., Oliveri, F., Coco, B., Salvati, A., Romagnoli, V., Surace, L., and Vatteroni, M. (2022). Different Kinetics of HBV-DNA and HBsAg in HCV Coinfected Patients during DAAs Therapy. J. Clin. Med., 11.","DOI":"10.3390\/jcm11051406"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12929-024-01094-7","article-title":"HBV DNA integration and somatic mutations in HCC patients with HBV-HCV dual infection reveals profiles intermediate between HBV- and HCV-related HCC","volume":"32","author":"Li","year":"2025","journal-title":"J. Biomed. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Li, F., Feng, Y., Liu, X., Hao, J., Wang, D., Hu, H., Song, C., Hu, J., Zhao, Q., and Liang, H. (2024). HBV and HCV Co-Infection in Chinese Newly Diagnosed HIV+ Subjects in 2015 and 2023: A Cross-Sectional Study. Pathogens, 13.","DOI":"10.3390\/pathogens13050367"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1080\/15321819.2024.2349009","article-title":"Seroprevalence and co-infection of HBV, HCV, and HIV among patients visiting selected hospitals in Anyigba, Kogi State","volume":"45","author":"Ali","year":"2024","journal-title":"J. Immunoass. Immunochem."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Annison, L., Hackman, H., Eshun, P.F., Annison, S., Forson, P., and Antwi-Baffour, S. (2022). Seroprevalence and effect of HBV and HCV co-infections on the immuno-virologic responses of adult HIV-infected persons on anti-retroviral therapy. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0278037"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/18\/2895\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:21:25Z","timestamp":1788942085000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/18\/2895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":44,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diagnostics16182895"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16182895","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]}}}