title: Cirrhosis is present in most patients with hepatitis B and hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Ju Dong
authors.initials: JD
authors.lastname: Yang
authors.forename: W Ray
authors.initials: WR
authors.lastname: Kim
authors.forename: Ritika
authors.initials: R
authors.lastname: Coelho
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Mettler
authors.forename: Joanne T
authors.initials: JT
authors.lastname: Benson
authors.forename: Schuyler O
authors.initials: SO
authors.lastname: Sanderson
authors.forename: Terry M
authors.initials: TM
authors.lastname: Therneau
authors.forename: Bohyun
authors.initials: B
authors.lastname: Kim
authors.forename: Lewis R
authors.initials: LR
authors.lastname: Roberts
mesh_terms: 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