Previous exposure to Hepatitis B virus and occult Hepatitis B virus infection may have an role in hepatocellular carcinoma in patients with chronic liver disease related to Hepatitis C virus.
Dr Kazuki Ikeda and colleagues from Japan prospectively studied the association between antibody to Hepatitis B core antigen and clinical outcomes in patients with Hepatitis C virus-related chronic liver disease.
|Hepatocellular carcinoma was diagnosed in 60% with anti-Hep B core antigen|
|Annals of Internal Medicine|
The team assessd 872 patients with chronic Hepatitis C virus infection, of which 597 had chronic Hepatitis, and 275 had cirrhosis.
The research team measured incidence of hepatocellular carcinoma on follow-up from 1995 to 2005.
Only 846 of the 872 enrolled patients were followed up.
The team found that hepatocellular carcinoma occurred in 28% of patients.
Among patients with cirrhosis, hepatocellular carcinoma was diagnosed in 60% with anti-Hepatitis B core antigen.
The researchers noted that hepatocellular carcinoma was diagnosed in 45% without Hepatitis B virus-related serologic markers.
Of 224 patients with chronic hepatitis who had interferon monotherapy, 41% had sustained or transient disappearance of Hepatitis C virus RNA.
None of the anti-Hepatitis B core antigen-negative patients who had a virologic response to interferon therapy developed hepatocellular carcinoma.
The researchers observed that cancer was diagnosed in 4 of 37 anti-Hepatitis B core antigen -positive patients with a virologic response to interferon.
On further analysis, the team found that anti-Hepatitis B core antigen-positive results on serologic testing was an independent risk factor in patients with cirrhosis.
The researchers undertook only 1 assessment of smoking and alcohol consumption at study entry.
The team reported that they did not precisely determine the duration of smoking or alcohol use.
Dr Ikeda's team concluded, " Anti-Hepatitis B core antigen-positive results on serologic testing are a marker of high risk for hepatocellular carcinoma among patients with Hepatitis C virus-related cirrhosis."
"Interferon therapy might be less effective in preventing hepatocellular carcinoma among patients with chronic Hepatitis C who are anti-Hepatitis B core antigen-positive."