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Occult hepatitis B virus infection is associated with the development of hepatocellular carcinoma in chronic hepatitis C patients
Author(s) -
Squadrito Giovanni,
Pollicino Teresa,
Cacciola Irene,
Caccamo Gaia,
Villari Daniela,
La Masa Tiziana,
Restuccia Tea,
Cucinotta Eugenio,
Scisca Claudio,
Magazzu Domenico,
Raimondo Giovanni
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21702
Subject(s) - medicine , hepatocellular carcinoma , hbsag , occult , hepatitis b virus , cirrhosis , hepatitis b , gastroenterology , liver cancer , cohort , liver disease , cancer , hepatitis , liver biopsy , biopsy , immunology , pathology , virus , alternative medicine
BACKGROUND Occult hepatitis B virus (HBV) infection frequently occurs in patients with HBV surface antigen (HBsAg)‐negative chronic liver disease, and much evidence suggests that it is a risk factor for hepatocellular carcinoma (HCC) development. However, to the authors' knowledge, no follow‐up study has been performed to date evaluating HCC occurrence over time in chronic hepatitis patients with or without occult HBV infection. METHODS A cohort of the 380 HBsAg‐negative chronic hepatitis patients attending the study institution between 1991–2000 were evaluated and tested for occult HBV DNA by analysis of liver biopsy specimens. RESULTS There were 135 patients (35.5%) with occult HBV and 245 patients (64.5%) without occult HBV. Cirrhosis was significantly associated with occult HBV infection ( P = 0.01). One hundred thirty‐four of these patients were followed for a minimum of 50 months (median, 82.8 ± 32.6 mos). Fifty‐three patients (39%) were occult HBV carriers and 81 (61%) were not. Nine patients developed HCC during the follow‐up; eight were positive and one was negative for occult HBV ( P = 0.002). CONCLUSIONS The current observational cohort study showed that, among the HBsAg‐negative patients with chronic hepatitis, HCC develops for the most part in carriers of occult HBV. Therefore, the evaluation of HBV genomes in chronic hepatitis patients appears to be a powerful tool for the identification of individuals at higher risk of HCC development. Cancer 2006. © 2006 American Cancer Society.