HBsAg 음성, anti-HCV 음성인 알코올간경변증에서 anti-HBc 양성 혹은 B형간염바이러스 잠재감염이 간세포암종 발생에 미치는 영향
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
2
조회
0
다운로드
1
인용
0
참고문헌
초록
Background/Aims: 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). Conclusions: 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.
Abstract
Background/Aims: 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). Conclusions: 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.
참고문헌 (32)
- Lee CH, "Perspective of chronic liver disease in Korea", pp.1~7 (2005), Koonja
- Seitz HK, "Pathogenetic mechanisms of upper aerodigestive tract cancer in alcoholics", Int J Cancer, 108, pp.483~487 (2004)
- Doll R, "Alcoholic beverages and cancers of the digestive tract and larynx", pp.351~393 (1995), Blackwell
- Corrao G, "A meta-analysis of alcohol consumption and the risk of 15 diseases", Prev Med, 38, pp.613~619 (2004)
- McKillop IH, "Alcohol and liver cancer", Alcohol, 35, pp.195~203 (2005)
- Voigt MD, "Alcohol in hepatocellular cancer", Clin Liver Dis, (9), pp.151~169 (2005)
- Stickel F, "Cocarcinogenic effects of alcohol in hepatocarcinogenesis", Gut, 51, pp.132~139 (2002)
- Corrao G, "Independent and combined action of hepatitis C virus infection and alcohol consumption on the risk of symptomatic liver cirrhosis", Hepatology, 27, pp.914~919 (1998)
- Colombo M, "Malignant neoplasm of the liver", pp.1377~1403 (2003), Lippincott Williams & Wilkins
- Benvegnu L, "Concurrent hepatitis B and C virus infection and risk of the hepatocellular carcinoma in cirrhosis", Cancer, 74, pp.2442~2448 (1994)
- Chung NS, "A comparative cross-sectional study of the development of hepatocellular carcinoma in patients with liver cirrhosis caused by hepatitis B virus, alcohol, or combination of hepatitis B virus and alcohol", Korean J Gastroenterol, 49, pp.369~375 (2007)
- Conjeevaram HS, "Occult hepatitis B virus infection: a Hidden menace?", Hepatology, 34, pp.204~206 (2001)
- Chemin I, "Clinical impact of occult HBV infection", J Clin Virol, 34(Suppl 1), pp.15~21 (2005)
- Lee HS, "Comparison of the incidence of hepatocellular carcinoma in HBV-and HCV- associated liver cirrhosis: a prospective study", Korean J Hepatol, 2, pp.21~28 (1996)
- Kato Y, "Risk of hepatocellular carcinoma in patients with cirrhosis in Japan", Cancer, 74, pp.2234~2238 (1994)
- Kim CM, "The pathogenesis of hepatocellular carcinoma", pp.656~663 (2000), Ilchokak
- Lee HS, "A prospective study on the incidence and risk factors of the development of hepatocellular carcinoma in patients with liver cirrhosis in Korea", Korean J Gastroenterol, 25, pp.116~122 (1993)
- Fattovich G, "Hepatocellular carcinoma in cirrhosis: incidence and risk factors", Gastroenterology, 127(Suppl 1), pp.35~50 (2004)
- Lee CH, "Alcoholic liver disease", pp.578~583 (2000), Ilchokak
- Uetake S, "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", Alcohol Clin Exp Res, 37(Suppl 8), pp.47~51 (2003)
- Lee HS, "Molecular-biologic and serologic diagnosis of HBV infection", pp.13~21 (1998), Koonja
- Brechot C, "Persistent hepatitis B virus infection in subjects without hepatitis B surface antigen: clinically significant or purely “Occult”?", Hepatology, 34, pp.194~203 (2001)
- Torbenson M, "Occult hepatitis B", Lancet Infect Dis, 2, pp.479~486 (2002)
- Paterlini P, "Polymerase chain reaction to detect hepatitis B virus DNA and RNA sequences in primary liver cancers from patients negative for hepatitis B surface antigen", N Engl J Med, 323, pp.80~85 (1990)
- Pollicino T, "Hepatitis B virus maintains its pro- oncogenic properties in the case of occult HBV infection", Gastroenterology, 126통권 : 102, pp.110~ (2004)
- Kim YS, "Detection of intrahepatic HBV DNA in HBeAg-negative liver diseases", Korean J Hepatol, 12, pp.201~208 (2006)
- Shiota G, "Occult hepatitis B virus infection in HBs antigen-negative hepatocellular carcinoma in a Japanese population: involvement of HBx and p53", J Med Virol, 62, pp.151~158 (2000)
- Hui CK, "Kinetics and risk of de novo hepatitis B infection in HBsAg-negative patients undergoing cytotoxic chemotherapy", Gastroenterology, 131, pp.59~68 (2006)
- Yotsuyanagi H, "Virologic analysis of non-B, non-C hepatocellular carcinoma in Japan: frequent involvement of hepatitis B virus", J Infect Dis, 181, pp.1920~1928 (2000)
- Chu CM, "HBsAg seroclearance in asymptomatic carriers of high endemic areas: appreciably high rates during a long-term follow-up", Hepatology, 45, pp.1187~1192 (2007)
- McMahon BJ, "Serologic and clinical outcomes of 1536 Alaska Natives chronically infected with hepatitis B virus", Ann Intern Med, 135, pp.759~768 (2001)
- Ahn SH, "Long-term clinical and histological outcomes in patients with spontaneous hepatitis B surface antigen seroclearance", J Hepatol, 42, pp.188~194 (2005)