title: [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].
abstract: OBJECTIVE
  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.
authors: Department of Internal Medicine, Gachon Medical School Gil Medical Center, Incheon, Korea.
authors: Min Ju
authors: MJ
authors: Kim
authors: Oh Sang
authors: OS
authors: Kwon
authors: Nak So
authors: NS
authors: Chung
authors: Seo Young
authors: SY
authors: Lee
authors: Hyuk Sang
authors: HS
authors: Jung
authors: Dong Kyun
authors: DK
authors: Park
authors: Yang Suh
authors: YS
authors: Ku
authors: Yu Kyung
authors: YK
authors: Kim
authors: Yun Soo
authors: YS
authors: Kim
authors: Ju Hyun
authors: JH
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens