Cirrhosis is present in most patients with hepatitis B and hepatocellular carcinoma.
OBJECTIVE
There are few data available about the prevalence or effects of cirrhosis in patients with hepatocellular carcinoma (HCC) from viral hepatitis. We compared patients with HCC and hepatitis B virus (HBV) or hepatitis C virus (HCV) infections to determine the proportions of cirrhosis in each group, virologic and tumor characteristics, and overall survival.


METHODS
This analysis included patients with HBV (n = 64) or HCV (n = 118) infection who were diagnosed with HCC at the Mayo Clinic in Rochester, Minnesota from 1994-2008; groups were matched for age and sex. The diagnosis of cirrhosis was based on histology and, if histologic information was insufficient or unavailable, clinical indicators that included ascites or varices, thrombocytopenia or splenomegaly, and radiographic configuration of cirrhosis. Virologic characteristics, tumor stage, and patient survival were also assessed.


RESULTS
The prevalence of histologic cirrhosis was 88% among patients with HBV infection and 93% among those with HCV infection (P = .46). When the most inclusive criteria for cirrhosis were applied, cirrhosis was present in 94% of patients with HBV and 97% with HCV (P = .24). Among HCV patients, 5.2% were negative for HCV RNA after antiviral treatment; 63.4% of HBV patients had HBV DNA <2000 IU/mL with or without treatment. Patients with HBV tended to have less surveillance and more advanced stages of HCC, without differences in survival from those with HCV infection (P = .75).


CONCLUSIONS
Most patients with HCC and chronic viral hepatitis had evidence of cirrhosis, including those with HBV infection and those without active viral replication.
Yang
Ju Dong
JD
Mayo Clinic College of Medicine, Rochester, MN, USA.
Kim
W Ray
WR
Coelho
Ritika
R
Mettler
Teresa A
TA
Benson
Joanne T
JT
Sanderson
Schuyler O
SO
Therneau
Terry M
TM
Kim
Bohyun
B
Roberts
Lewis R
LR
D000368:Aged; D001201:Ascites / Q000175:diagnosis; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000473:pathology*; D004932:Esophageal and Gastric Varices / Q000175:diagnosis; D005260:Female; D005355:Fibrosis / Q000453:epidemiology* / Q000473:pathology*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000473:pathology; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D013163:Splenomegaly / Q000175:diagnosis; D013921:Thrombocytopenia / Q000175:diagnosis