Clinicopathological study of occult hepatitis B virus infection in hepatitis C virus-associated hepatocellular carcinoma

Abstract

Background Occult hepatitis B virus infection (OBI) frequently occurs in patients with chronic hepatitis C (CHC) infection, but the influence of OBI on CHC outcome is still uncertain. The aim of the present study was to clarify the clinical and pathological characteristics of OBI in CHC-related hepatocellular carcinoma (HCC). Patients and methods DNA was obtained from serum and tumor tissue of patients with hepatitis C virus (HCV)-related HCC with negative HBsAg and from patients with HCV-related liver cirrhosis. HBV-DNA was detected using qPCR. Clinicopathological features were compared between patients with HCC with and without OBI. Results On the basis of positive serum and tissue HBV-DNA typing, the overall frequency of OBI was 50% in patients with HCV-related HCC. HBV genotype D was the most dominant, constituting 35.3% of HCC cases. Almost 80% of patients with OBI had anti-HBc, whereas 20% of patients had no serological markers. Tissue HBV-DNA showed significant association with positive serum HBV-DNA, anti-HBc, and genotype D. There were no clinical differences between patients with HCC with and without OBI; however, patients with OBI tended to be younger. HCC cases with positive OBI were significantly associated with positive anti-HBc antibodies and late histological grades (3–4). Multivariate logistic regression analysis revealed that the presence of OBI was a predictor of more advanced HCC histological grades in patients with HCV infection. Conclusion OBI was detected in 50% of HCV-infected patients with HCC. OBI was strongly associated with the presence of anti-HBc antibodies. Patients with HCC with positive OBI were younger and had more advanced HCC histological grades.

Occult hepatitis B infection and hepatocellular carcinoma: Epidemiology, virology, hepatocarcinogenesis and clinical significance

“…While there were no clinical differences between patients with and without OBI (gender, serum transaminases, platelet count, albumin, bilirubin, prothrombin time, alphafetoprotein, Child-Pugh score), those with OBI were younger (48.4 year-old for OBI compared to 51.4 year-old for non-OBI), and were associated with more advanced histological grades of HCC (odds ratio 3.69). 84 This supports the premise that OBI may play a synergistic role in the occurrence of HCC in HCV coinfected patients, especially in patients with advanced fibrosis and cirrhosis.…”

Occult Hepatitis B Virus Infection: An Update

“…Analogously, many studies from Asia and Europe have shown that the prevalence of OBI is significantly higher in anti-HCV-positive patients with HCC than in those with CLD or in healthy controls [ 21 , 148 , 149 , 150 , 151 ]. An Egyptian study including anti-HCV-positive patients with HCC who underwent resection or liver transplantation showed that those with OBI (50% of the subjects analyzed) were younger and with a worse histological liver tumor grade [ 152 ]. Two observational cohort studies (with a median follow-up of 6.9 years and 11 years) analyzing the cumulative incidence of HCC in both cirrhotic and non-cirrhotic anti-HCV-positive subjects with and without OBI, showed that OBI carriers had a higher incidence of HCC than patients without OBI [ 128 , 153 ].…”

Comparison of clinical features and outcomes between HBV-related and non-B non-C hepatocellular carcinoma

“…Previous studies have compared the clinicopathological features and prognosis of HCC patients with HBV and HCV infections [17][18][19]. However, both of them are caused by chronic viral infection.…”