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News

Markers of hepatocellular carcinoma in Hep C-related cirrhosis

Anti-Hep B core antigen-positive results on serologic testing are a marker of hepatocellular carcinoma risk in Hep C virus-related cirrhosis, shows this month's Annals of Internal Medicine.

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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."

Ann Int Med 2007: 146(9): 649-56
03 May 2007

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