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

Authors

  • Anna S. Lok,

    Corresponding author
    1. Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI
    • Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, 1500 E Medical Center Drive, 3912 Taubman Center, Ann Arbor, MI 48109
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    • Fax: 734-936-7392

  • James E. Everhart,

    1. Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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  • Adrian M. Di Bisceglie,

    1. Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO
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  • Hae-Young Kim,

    1. New England Research Institutes, Watertown, MA
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  • Munira Hussain,

    1. Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI
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  • Timothy R. Morgan,

    1. Division of Gastroenterology, University of California, Irvine, Irvine, CA
    2. Gastroenterology Service, VA Long Beach Healthcare System, Long Beach, CA
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  • and the HALT-C Trial Group


  • Potential conflict of interest: The following authors have financial relationships with Hoffmann-La Roche, Inc. (now Genentech): A. S. Lok is a consultant and receives research support; A. M. Di Bisceglie is a consultant and receives research support; and T. R. Morgan receives research support.

  • This is publication #68 of the HALT-C Trial, which has been registered with clinicaltrials.gov (#NCT00006164).

  • §

    National Institute of Diabetes & Digestive & Kidney Diseases (contract numbers are listed in the Acknowledgment section). Additional support was provided by the National Institute of Allergy and Infectious Diseases, the National Cancer Institute, the National Center for Minority Health and Health Disparities, and by General Clinical Research Center and Clinical and Translational Science Center grants from the National Center for Research Resources, National Institutes of Health (grant numbers are listed in the Acknowledgment section). Additional funding to conduct this study was supplied by Hoffmann-La Roche, Inc. (now Genentech) through a Cooperative Research and Development Agreement with the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health

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. (Hepatology 2011;)

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