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KMID : 1103920080140010067
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Korean Journal of Hepatology
2008 Volume.14 No. 1 p.67 ~ p.76
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The significance of anti-HBc and occult hepatitis B virus infection in the occurrence of hepatocellular carcinoma in patients with HBsAg and anti-HCV negative alcoholic cirrhosis
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Kim Min-Ju
Kwon Oh-Sang
Chung Nak-so
Lee Seo-Young
Jung Hyuk-Sang
Park Dong-Kyun
Koo Yang-Suh
Kim Yu-Kyung
Kim Yun-Soo
Kim Ju-Hyun
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Abstract
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Background : Alcohol and the hepatitis B virus (HBV) exert synergistic effects in hepatocelluar carcinogenesis. We aimed to elucidate the clinical significance of the antibody to hepatitis B core antigen (anti-HBc) and occult HBV infection on the development of hepatocellular carcinoma (HCC) in patients with alcoholic liver cirrhosis (LC).
Methods : Patients with alcoholic LC alone (n=193) or combined with HCC (n=36), who did not have HBsAg or antibody to hepatitis C virus were enrolled. Clinical data and laboratory data including anti-HBc were investigated at enrollment. The polymerase chain reaction was applied to HBV DNA using sera of patients with HCC or LC after age and sex matching.
Results : Patients with HCC were older (60±11 years vs. 53±10 years, mean±SD, P<0.001), more likely to be male (100% vs. 89%, P=0.03), and had a higher positive rate of anti-HBc (91.2% vs. 77.3%, P=0.067), and a higher alcohol intake (739±448 kg vs. 603±409 kg, P=0.076) than those with LC. Age was the only significant risk factor for HCC revealed by multiple logistic regression analysis (odds ratio, 1.056; P=0.003). The positive rate of anti-HBc and alcohol intake did not differ in age- and sex-matched subjects between the LC (n=32) and HCC (n=31) groups. However, the detection rate of serum HBV DNA was higher in the HCC group (48.4%) than in the LC group (0%, P<0.001).
Conclusion : Anti-HBc positivity is not a risk factor for HCC. However, occult HBV infection may be a risk factor for HCC in patients with alcoholic LC. (Korean J Hepatol 2008;14:67-76)
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KEYWORD
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Alcohol, Anti-HBc, Hepatocellular carcinoma, Liver cirrhosis, Occult HBV infection
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