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

doi:2008.14.1.67

Korean J Hepatol > Volume 14(1); 2008 > Article

The Korean Journal of Hepatology 2008;14(1): 67-76.
doi: https://doi.org/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

Min Ju Kim , Oh Sang Kwon , Nak So Chung , Seo Young Lee , Hyuk Sang Jung , Dong Kyun Park , Yang Suh Ku , Yu Kyung Kim , Yun Soo Kim , Ju Hyun Kim

Department of Internal Medicine. Gachon Medical School Gil Medical Center, Incheon, Korea

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. (Korean J Hepatol 2008;14:67-76)

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