Anti-HCV positive hepatocellular carcinoma in cirrhosis. Prevalence, risk factors and clinical features.
Recent reports indicate that hepatitis C virus (HCV) may play a role in the pathogenesis of hepatocellular carcinoma in cirrhotics. Using an ELISA test, we evaluated the prevalence of anti-HCV antibodies in 97 patients with hepatocellular carcinoma (HCC) in cirrhosis and in a group of 223 patients, including: 49 patients with HBsAg-positive chronic liver disease (CLD), 42 with alcoholic CLD, 110 with cryptogenic CLD and 22 with post-transfusional HBsAg-negative CLD. All diagnoses were histologically confirmed. Overall, anti-HCV-positive HCC were 64% of the total, with no statistically significant difference with respect to CLD (60.9%). The prevalence of anti-HCV was higher in cryptogenic HCC (80%) than in HBsAg-positive (60%) or alcoholic HCC (42.8%) (p less than 0.005). When HCC and cirrhosis of similar putative etiology were considered, anti-HCV prevalence was significantly higher in HCC than in cirrhosis only in the groups of patients with alcoholic liver damage (60% in HCC vs. 38% in cirrhosis, p less than 0.005). In HBsAg-positive patients, anti-HCV prevalence was twice as high in HCC than in CLD, but the difference was not statistically significant. Overall, anti-HCV prevalence in HCC was significantly higher than in alcoholic or HBsAg-positive CLD (p less than 0.001 and p less than 0.01, respectively) but lower than in cryptogenic CLD (p less than 0.001). Association between anti-HCV and anti-HBc was significantly more prevalent in patients with CLD than in those with HCC.(ABSTRACT TRUNCATED AT 250 WORDS)
Farinati
F
F
Cattedra Malattie Apparato Digerente, Università Di Padova, Italy.
Fagiuoli
S
S
De Maria
N
N
Chiaramonte
M
M
Aneloni
V
V
Ongaro
S
S
Salvagnini
M
M
Naccarato
R
R
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D018937:Hepatitis C Antibodies; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000382:microbiology*; D008113:Liver Neoplasms / Q000150:complications / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies