Korean J Hepatol.  2008 Mar;14(1):67-76. 10.3350/kjhep.2008.14.1.67.

The significance of anti-HBc and occult hepatitis B virus infection in the occurrence of hepatocellular carcinoma in patients with HBsAg and anti-HCV negative alcoholic cirrhosis

• Kim MJ
• Kwon OS
• Chung NS
• Lee SY
• Jung HS
• Park DK
• Ku YS
• Kim YK
• Kim YS
• Kim JH

• KMID: 1073331
• DOI: http://doi.org/10.3350/kjhep.2008.14.1.67

Abstract

BACKGROUND/AIMS: Alcohol and the hepatitis B virus (HBV) exert synergistic effects in hepatocelluar carcinogenesis. We aimed to elucidate the clinical significance of the antibody to hepatitis B core antigen (anti-HBc) and occult HBV infection on the development of hepatocellular carcinoma (HCC) in patients with alcoholic liver cirrhosis (LC). METHODS: Patients with alcoholic LC alone (n=193) or combined with HCC (n=36), who did not have HBsAg or antibody to hepatitis C virus were enrolled. Clinical data and laboratory data including anti-HBc were investigated at enrollment. The polymerase chain reaction was applied to HBV DNA using sera of patients with HCC or LC after age and sex matching. RESULTS: Patients with HCC were older (60+/-11 years vs. 53+/-10 years, mean+/-SD, P<0.001), more likely to be male (100% vs. 89%, P=0.03), and had a higher positive rate of anti-HBc (91.2% vs. 77.3%, P=0.067), and a higher alcohol intake (739+/-448 kg vs. 603+/-409 kg, P=0.076) than those with LC. Age was the only significant risk factor for HCC revealed by multiple logistic regression analysis (odds ratio, 1.056; P=0.003). The positive rate of anti-HBc and alcohol intake did not differ in age- and sex-matched subjects between the LC (n=32) and HCC (n=31) groups. However, the detection rate of serum HBV DNA was higher in the HCC group (48.4%) than in the LC group (0%, P<0.001). CONCLUSIONS: Anti-HBc positivity is not a risk factor for HCC. However, occult HBV infection may be a risk factor for HCC in patients with alcoholic LC.

Keyword

Alcohol; Anti-HBc; Hepatocellular carcinoma; Liver cirrhosis; Occult HBV infection

MeSH Terms

Adult
Aged
Antibodies, Viral/blood
Carcinoma, Hepatocellular/diagnosis/epidemiology/*etiology
DNA, Viral/analysis
Female
Hepatitis B/*complications/diagnosis
Hepatitis B Core Antigens/*immunology
Hepatitis B Surface Antigens/immunology
Hepatitis B virus/genetics/immunology/isolation & purification
Hepatitis C/complications/diagnosis
Humans
Liver Cirrhosis, Alcoholic/*complications/diagnosis/epidemiology
Liver Neoplasms/diagnosis/epidemiology/*etiology
Male
Middle Aged
Risk Factors