Lack of correlation between serum anti-HBcore detectability and hepatocellular carcinoma in patients with HCV-related cirrhosis.
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.
Stroffolini
Tommaso
T
Department of Gastroenterology, Ospedale San Giacomo, Roma, Italy.
Almasio
Piero Luigi
PL
Persico
Marcello
M
Bollani
Simona
S
Benvegnù
Luisa
L
Di Costanzo
Giovangiuseppe
G
Pastore
Giuseppe
G
Aghemo
Alessio
A
Stornaiuolo
Gianfranca
G
Mangia
Alessandra
A
Andreone
Pietro
P
Stanzione
Maria
M
Mazzella
Giuseppe
G
Saracco
Giorgio
G
Del Poggio
Paolo
P
Bruno
Savino
S
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
D000914:Antibodies, Viral; D006512:Hepatitis B Core Antigens