title: Lack of correlation between serum anti-HBcore detectability and hepatocellular carcinoma in patients with HCV-related cirrhosis.
abstract: BACKGROUND
  While the likelihood of developing hepatocellular carcinoma (HCC) in patients coinfected with both HBV and HCV is increased, the role of previous exposure to HBV as a risk factor associated with tumor occurrence in subjects with HCV-related cirrhosis has not been fully investigated.
  
  
  OBJECTIVE
  To assess whether serum anti-HBc positivity, as a marker of previous HBV exposure, is associated with HCC development in HCV-related positive, hepatitis B surface antigen (HBsAg) negative patients with cirrhosis treated with alfa-interferon (IFN) monotherapy. PATIENTS AND: A database including 883 consecutive patients (557 men, mean age 54.7 yr) with histologically
  
  
  METHODS
  proven cirrhosis treated with IFN between 1992 and 1997 was analyzed. All subjects have been surveilled every 6 months by ultrasound. Independent predictors of HCC were assessed by Cox multiple regression analysis.
  
  
  RESULTS
  Mean follow-up was 96.1 months. Anti-HBc testing was available in 693 cases and, among them, 303 patients (43.7%) were anti-HBc seropositive. Anti-HBc positive patients were more often men (67.0%vs 58.7%, P= 0.03), had lower transaminase levels (3.3 +/- 2.0 vs 3.8 +/- 2.5 u.l.n., P= 0.004), and had higher rate of alcohol intake (38.3%vs 22.5%, P < 0.001) than anti-HBc negative patients. Overall, the incidence rates of HCC per 100 person-years were 1.84 (95% CI 1.34-2.47) in the anti-HBc positive patients and 1.86 (95% CI 1.41-2.42) in anti-HBc negative ones. By Cox multiple regression, there was no association of serum anti-HBc with HCC development (HR 1.03, 95% CI 0.69-1.52) or liver-related deaths incidence (HR 1.21; 95% CI 0.76-1.95).
  
  
  CONCLUSIONS
  In comparison with anti-HBc negative subjects, serum anti-HBc positive patients with HCV-related/HBsAg negative cirrhosis treated with IFN monotherapy did not show a greater risk of HCC.
authors.affiliation: Department of Gastroenterology, Ospedale San Giacomo, Roma, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Stroffolini
authors.forename: Piero Luigi
authors.initials: PL
authors.lastname: Almasio
authors.forename: Marcello
authors.initials: M
authors.lastname: Persico
authors.forename: Simona
authors.initials: S
authors.lastname: Bollani
authors.forename: Luisa
authors.initials: L
authors.lastname: Benvegnù
authors.forename: Giovangiuseppe
authors.initials: G
authors.lastname: Di Costanzo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pastore
authors.forename: Alessio
authors.initials: A
authors.lastname: Aghemo
authors.forename: Gianfranca
authors.initials: G
authors.lastname: Stornaiuolo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mangia
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
authors.forename: Maria
authors.initials: M
authors.lastname: Stanzione
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mazzella
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saracco
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Poggio
authors.forename: Savino
authors.initials: S
authors.lastname: Bruno
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology / Q000821:virology; D015331:Cohort Studies; D005260:Female; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006526:Hepatitis C / Q000097:blood* / Q000150:complications / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000914:Antibodies, Viral; D006512:Hepatitis B Core Antigens