Clinical significance of prior hepatitis B virus infection in patients with hepatitis C virus-related hepatocellular carcinoma.
BACKGROUND
The effect of prior hepatitis B virus (HBV) infection on the clinicopathologic findings for patients with hepatitis C virus (HCV) RNA and hepatocellular carcinoma (HCC) is still unclear.


METHODS
Of 59 patients who underwent liver resection for HCV-related HCC (</=2.0 cm in greatest dimension) without metastases between 1990 and 1997, 38 patients had anti-HB core antibody (anti-HBc) and did not have HB surface antigen in their sera (Group 1). Their clinicopathologic findings and outcomes after surgery were compared with those of the remaining 22 patients without anti-HBc (Group 2).


RESULTS
The proportion of well-differentiated HCC was significantly lower in Group 1 than in Group 2 (P = 0.0214). The percentage of patients with cirrhosis was significantly lower in Group 1 than in Group 2 (P = 0.0228). The cumulative survival rate was significantly lower in Group 1 than in Group 2 (P = 0.0224). The risk ratio of anti-HBc for shorter survival time was 3.817.


CONCLUSIONS
HCC more often developed before cirrhosis in patients with HCV RNA and anti-HBc than in patients positive for HCV RNA alone. Prior HBV infection was a risk factor for poor outcome after liver resection for patients infected with HCV.
Kubo
S
S
Second Department of Surgery, Osaka City University Medical School, Osaka, Japan.
Nishiguchi
S
S
Hirohashi
K
K
Tanaka
H
H
Tsukamoto
T
T
Hamba
H
H
Shuto
T
T
Yamamoto
T
T
Ikebe
T
T
Kinoshita
H
H
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology*; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis; D006511:Hepatitis B Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D018709:Statistics, Nonparametric; D016019:Survival Analysis
D006511:Hepatitis B Antigens; D012367:RNA, Viral