Analysis of Risk Factors for Hepatocellular Carcinoma in Patients With HBs Antigen‐ and Anti‐HCV Antibody‐Negative Alcoholic Cirrhosis: Clinical Significance of Prior Hepatitis B Virus Infection

Uetake, Shinichiro; Yamaguchi, Masayoshi; Itoh, Shigeo; Kawashima, Osamu; Takeda, Kunihiko; Ohata, Mitsuru

doi:10.1097/01.alc.0000079449.47468.b0

Cited by 51 publications

(40 citation statements)

References 29 publications

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“…Of the 26 studies included, 14 were conducted in Japan, [24,26,29,34,35,37–40,42–44,46,47] 5 in Italy, [27,30,36,41,45] 4 in the United States, [25,31,33] 1 each in Australia, [28] China, [49] and South Korea. [32] Fifteen studies enrolled patients with different stages of liver disease (chronic hepatitis or cirrhosis), [24,26,28,30,31,33,35–37,39,40,42,46,47,49] 2 studies involved patients with chronic hepatitis, [34,44] 5 studies patients with cirrhosis, [32,38,41,43,45] and 4 included also healthy controls. [25,27,29,48] The etiologic agent of liver disease was HCV in 18 studies, [24,28,29,31,33–37,39–47] alcohol in 2 studies, [32,38] primary biliary cirrhosis in 1, [49] whereas 5 studies [25–27,30,48] enrolled patients with a mixed etiology, HCV infection, alcohol abuse, and/or other nonspecified etiology.…”

Section: Resultsmentioning

confidence: 99%

Association between anti-HBc positivity and hepatocellular carcinoma in HBsAg-negative subjects with chronic liver disease

Coppola¹,

Onorato²,

Sagnelli³

et al. 2016

Medicine

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A meta-analysis was performed to ascertain to what extent hepatitis B surface antigen (HBsAg)-negative/anti-hepatitis B core (anti-HBc)-positive subjects with chronic liver disease are at a higher risk of developing hepatocellular carcinoma (HCC) than the anti-HBc-negative.All studies included had to fulfill the following characteristics and inclusion criteria: they investigated the relationship between HBsAg-negative/anti-HBc-positive serology and the occurrence of HCC, whether a case–control or cohort study, they provided relative risk (RR) or odds ratios (ORs) and 95% confidence intervals (CIs), were available as a full text written in English, and were published and indexed up to April 2015.Twenty-six original studies met the inclusion criteria, allowing a meta-analysis on 44,553 patients. The risk of HCC among the 9986 anti-HBc-positive subjects was 67% higher than in the 34,567 anti-HBc-negative (95% CI = 1.44–1.95, P < 0.0001). The results were similar when groups of patients with a different stage of liver disease (patients with chronic liver disease, patients with cirrhosis), with different ethnicity (Asian and non-Asian) and etiology (HCV and non-HCV) were considered. The risk of HCC was significantly higher in the 651 anti-HBs/anti-HBc-positive patients (RR = 1.36; 95% CI = 1.17–1.58, P = 0.03) and in the 595 anti-HBs-negative/anti-HBc-positive subjects (RR = 2.15; 95% CI = 1.58–2.92, P < 0.0001) than in the 1242 anti-HBs/anti-HBc negative. However, the RR from 8 studies indicated that the risk of HCC was 35% lower among the anti-HBs/anti-HBc-positive subjects compared to the anti-HBs-negative/anti-HBc-positive (RR = 0.65; 95% CI = 0.52–0.8, P < 0.0001).This meta-analysis shows that in HBsAg-negative subjects with chronic liver disease, anti-HBc positivity is strongly associated with the presence of HCC, an association observed in all subgroups according to the stage of the disease, etiology, and ethnicity.

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Section: Resultsmentioning

confidence: 99%

Association between anti-HBc positivity and hepatocellular carcinoma in HBsAg-negative subjects with chronic liver disease

Coppola¹,

Onorato²,

Sagnelli³

et al. 2016

Medicine

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“…Hepatitis virus infection may modify the prognosis for alcoholic liver cirrhosis patients, especially in the development of carcinogenesis [25,26] . In order to investigate the posttransplant outcome of pa- tients with HCC in ALD as well as the ethical issues which are associated with this clinical condition, patients with active or chronic viral hepatitis infection were excluded.…”

Section: Discussionmentioning

confidence: 99%

Single-Center Experience on Liver Transplantation for Hepatocellular Carcinoma Arising in Alcoholic Cirrhosis: Results and Ethical Issues

Sotiropoulos¹,

Beckebaum²,

Lang³

et al. 2007

Eur Surg Res

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Background: Liver transplantation is currently recognized as the optimal treatment for both early hepatocellular carcinoma in the setting of cirrhosis (HCC) as well as for alcoholic liver disease (ALD). The purpose of this study was to evaluate the outcome of patients with HCC and ALD in the absence of viral hepatitic infections. Methods: Twelve recipients were transplanted with a diagnosis of HCC and ALD in the absence of viral hepatitis during a 6-year period. Nine received deceased donor livers, and 3 live donor grafts. Our results were compared to those obtained by a search of the world literature. Results: The postoperative course was uneventful in all but one patient. All recipients experienced a good quality of life postoperatively. Three-year overall and recurrence-free survival rates were 82 and 73%, respectively. Nine patients are currently alive, after a median follow-up of 29 months. Conclusion: This is the first study to evaluate liver transplantation for HCC in ALD. Although outcomes are excellent, the evaluation of patients with ALD and HCC constitutes a challenging topic in transplantation surgery, especially when live liver donation is considered. An interdisciplinary structured approach is recommended, with special emphasis on ethical considerations.

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“…Chronic HBV infection is demonstrable in about 80% of HCC cases worldwide, and HCV infection in many of the HBV-negative HCC patients. Exposure to aflatoxins, a food contaminant largely derived from spoiled corn or wheat or groundnuts (peanuts), and heavy alcohol consumption, have long been associated with development of HCC (Sylla et al, 1999;Chen and Chen, 2002;Uetake et al, 2003). These multifactorial hypotheses result from epidemiologic observations.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Viruses, chemicals and co-carcinogenesis

Haverkos

2004

Oncogene

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Analysis of Risk Factors for Hepatocellular Carcinoma in Patients With HBs Antigen‐ and Anti‐HCV Antibody‐Negative Alcoholic Cirrhosis: Clinical Significance of Prior Hepatitis B Virus Infection

Abstract: These epidemiologic results suggest that heavy cumulative alcohol intake and prior exposure to HBV infection are risk factors for the development of HCC in patients with HBs Ag- and anti-HCV-negative alcoholic cirrhosis.

Cited by 51 publications

References 29 publications

Association between anti-HBc positivity and hepatocellular carcinoma in HBsAg-negative subjects with chronic liver disease

Association between anti-HBc positivity and hepatocellular carcinoma in HBsAg-negative subjects with chronic liver disease

Single-Center Experience on Liver Transplantation for Hepatocellular Carcinoma Arising in Alcoholic Cirrhosis: Results and Ethical Issues

Viruses, chemicals and co-carcinogenesis

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