Anticardiolipin antibodies in chronic hepatitis B and chronic hepatitis D infection, and hepatitis B-related hepatocellular carcinoma. Relationship with portal vein thrombosis.
OBJECTIVE
To assess the presence of anticardiolipin antibodies (ACAs) in patients with chronic hepatitis B virus (HBV) infection, chronic hepatitis D virus (HDV) infection and HBV-related hepatocellular carcinoma (HCC) and to associate this with the incidence of portal vein thrombosis (PVT) in HCC patients.


METHODS
Sixty-five cirrhotic patients with HBV-related HCC, 28 naive patients with chronic HBV infection and 14 naive patients with chronic HDV infection were enrolled prospectively in the study. Thirty-two healthy blood donors were used as controls. The ACAs (immunoglobulin G and immunoglobulin M) were measured using an enzyme-linked immunosorbent assay system. Statistical analysis used non-parametric methodology (chi-squared test, Student t-test and Fisher exact test, P value<0.05).


RESULTS
Eleven of the 65 patients with HCC (16.9%) showed a positive ACA titre and 22 of the patients (34%) had PVT. Of these patients, eight (36%) had a positive ACA titre. In contrast, from the 43 patients without PVT, only three (11%) showed a positive titre. From the 28 HBV patients, six (21.5%) had a positive ACA titre, and six out of 14 (42.8%) HDV patients also showed a positive ACA titre. Three of the six ACA positive HBV patients presented an extrahepatic manifestation of the disease. One out of 32 control patients (3%) had positive ACAs.


CONCLUSIONS
Both chronic HBV and chronic HDV infections are potent stimulants for the production of ACAs. The presence of ACAs in a great proportion of HBV-cirrhosis-related HCC patients with PVT suggests their possible participation in thrombotic mechanisms and in the hypercoagulable state that occurs in advanced liver disease and HCC.
Elefsiniotis
Ioannis S
IS
Department of Hepatogastroenterology, University of Athens, Helena Venizelou Hospital, Athens, Greece. ielefs@acn.gr
Diamantis
Ioannis D
ID
Dourakis
Spyros P
SP
Kafiri
Georgia
G
Pantazis
Konstantinos
K
Mavrogiannis
Christos
C
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000276:immunology* / Q000821:virology; D016022:Case-Control Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000276:immunology*; D019701:Hepatitis D, Chronic / Q000150:complications / Q000276:immunology*; D006801:Humans; D008113:Liver Neoplasms / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011446:Prospective Studies; D020246:Venous Thrombosis / Q000276:immunology / Q000821:virology
D017153:Antibodies, Anticardiolipin