Occult and previous hepatitis B virus infection are not associated with hepatocellular carcinoma in United States patients with chronic hepatitis C

Anna S Lok, James E Everhart, Adrian M Di Bisceglie, Hae-Young Kim, Munira Hussain, Timothy R Morgan, HALT-C Trial Group, Gyongyi Szabo, Barbara F Banner, Maureen Cormier, Donna Giansiracusa, Herbert L Bonkovsky, Michelle Kelley, Bruce Bacon, Elizabeth M Brunt, Debra King, Jules L Dienstag, Raymond T Chung, Andrea E Reid, Atul K Bhan, Wallis A Molchen, David P Lundmark, Gregory T Everson, Marcelo Kugelmas, S Russell Nash, Jennifer DeSanto, Carol McKinley, Choon Park, William M Lee, Thomas E Rogers, Peter F Malet, Nicole Crowder, Rivka Elbein, Nancy Liston, Karen L Lindsay, Sugantha Govindarajan, Susan L Milstein, Robert J Fontana, Joel K Greenson, Pamela A Richtmyer, R Tess Bonham, Mitchell L Shiffman, Richard K Sterling, Melissa J Contos, A Scott Mills, Charlotte Hofmann, Paula Smith, Marc G Ghany, T Jake Liang, David Kleiner, Yoon Park, Elenita Rivera, Vanessa Haynes-Williams, Leonard B Seeff, Patricia R Robuck, Jay H Hoofnagle, Elizabeth C Wright, Chihiro Morishima, David R Gretch, Minjun Chung Apodaca, Rohit Shankar, Natalia Antonov, Kristin K Snow, Anne M Stoddard, Teresa M Curto, Zachary D Goodman, Fanny Monge, Michelle Parks, Gary L Davis, Guadalupe Garcia-Tsao, Michael Kutner, Stanley M Lemon, Robert P Perrillo, Gloria Borders, Brent Neuschwander-Tetri, Thomas Trouillot, John C Hoefs, Carol B Jones, Anna S Lok, James E Everhart, Adrian M Di Bisceglie, Hae-Young Kim, Munira Hussain, Timothy R Morgan, HALT-C Trial Group, Gyongyi Szabo, Barbara F Banner, Maureen Cormier, Donna Giansiracusa, Herbert L Bonkovsky, Michelle Kelley, Bruce Bacon, Elizabeth M Brunt, Debra King, Jules L Dienstag, Raymond T Chung, Andrea E Reid, Atul K Bhan, Wallis A Molchen, David P Lundmark, Gregory T Everson, Marcelo Kugelmas, S Russell Nash, Jennifer DeSanto, Carol McKinley, Choon Park, William M Lee, Thomas E Rogers, Peter F Malet, Nicole Crowder, Rivka Elbein, Nancy Liston, Karen L Lindsay, Sugantha Govindarajan, Susan L Milstein, Robert J Fontana, Joel K Greenson, Pamela A Richtmyer, R Tess Bonham, Mitchell L Shiffman, Richard K Sterling, Melissa J Contos, A Scott Mills, Charlotte Hofmann, Paula Smith, Marc G Ghany, T Jake Liang, David Kleiner, Yoon Park, Elenita Rivera, Vanessa Haynes-Williams, Leonard B Seeff, Patricia R Robuck, Jay H Hoofnagle, Elizabeth C Wright, Chihiro Morishima, David R Gretch, Minjun Chung Apodaca, Rohit Shankar, Natalia Antonov, Kristin K Snow, Anne M Stoddard, Teresa M Curto, Zachary D Goodman, Fanny Monge, Michelle Parks, Gary L Davis, Guadalupe Garcia-Tsao, Michael Kutner, Stanley M Lemon, Robert P Perrillo, Gloria Borders, Brent Neuschwander-Tetri, Thomas Trouillot, John C Hoefs, Carol B Jones

Abstract

Previous studies have suggested that prior exposure to hepatitis B virus (HBV) infection may increase the risk of development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C. The aim of this study was to compare the prevalence of previous or occult HBV infection in a cohort of hepatitis B surface antigen-negative patients with histologically advanced chronic hepatitis C in the United States who did or did not develop HCC. Stored sera from 91 patients with HCC and 182 matched controls who participated in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial were tested for hepatitis B core antibody (anti-HBc), hepatitis B surface antibody, and HBV DNA. Frozen liver samples from 28 HCC cases and 55 controls were tested for HBV DNA by way of real-time polymerase chain reaction. Anti-HBc (as a marker of previous HBV infection) was present in the serum of 41.8% HCC cases and 45.6% controls (P=0.54); anti-HBc alone was present in 16.5% of HCC cases and 24.7% of controls. HBV DNA was detected in the serum of only one control subject and no patients with HCC. HBV DNA (as a marker of occult HBV infection) was detected in the livers of 10.7% of HCC cases and 23.6% of controls (P=0.18).

Conclusion: Although almost half the patients in the HALT-C Trial had serological evidence of previous HBV infection, there was no difference in prevalence of anti-HBc in serum or HBV DNA in liver between patients who did or did not develop HCC. In the United States, neither previous nor occult HBV infection is an important factor in HCC development among patients with advanced chronic hepatitis C.

Trial registration: ClinicalTrials.gov NCT00006164.

Copyright © 2011 American Association for the Study of Liver Diseases.

Figures

Figure 1
Figure 1
Prevalence of anti-HBc and anti-HBs in the serum of HCC cases (n=91) and matched controls (n=182)
Figure 2
Figure 2
Prevalence of HBV DNA in the liver of HCC cases (n=28) and matched controls (n=55)

Source: PubMed

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