Effect of occult hepatitis B virus infection on the early-onset of hepatocellular carcinoma in patients with hepatitis C virus infection

Nakano,Masahito; Kawaguchi,Takumi; Nakamoto,Shingo; Kawaguchi,Atsushi; Kanda,Tatsuo; Imazeki,Fumio; Kuromatsu,Ryoko; Sumie,Shuji; Satani,Manabu; Yamada,Shingo; Torimura,Takuji; Kakuma,Tatsuyuki; Yokosuka,Osamu; Sata,Michio

doi:10.3892/or.2013.2700

Effect of occult hepatitis B virus infection on the early-onset of hepatocellular carcinoma in patients with hepatitis C virus infection

Authors:
- Masahito Nakano
- Takumi Kawaguchi
- Shingo Nakamoto
- Atsushi Kawaguchi
- Tatsuo Kanda
- Fumio Imazeki
- Ryoko Kuromatsu
- Shuji Sumie
- Manabu Satani
- Shingo Yamada
- Takuji Torimura
- Tatsuyuki Kakuma
- Osamu Yokosuka
- Michio Sata
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Affiliations: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan, Biostatistics Center, Kurume University, Kurume, Japan, Department of Biostatistics, Kurume University Graduate School of Medicine, Kurume, Japan
Published online on: August 27, 2013 https://doi.org/10.3892/or.2013.2700
Pages: 2049-2055

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Abstract

Although overt hepatitis B virus (HBV) infection promotes the onset of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-infected patients, the effect of occult HBV infection remains unclear. The aim of this study was to investigate the effect of occult HBV infection on the early-onset of HCC in HCV-infected patients. A total of 173 HCC patients with HCV infection were enrolled and classified into 2 groups according to the median age of HCC onset: the early-onset group (n=91; 61.1±5.6 years) and the late-onset group (n=82; 73.8±3.7 years). Independent factors associated with the early-onset of HCC were assessed by multivariate analysis. In the overall analysis, independent risk factors for the early-onset of HCC were the white blood cell count and alanine aminotransferase level, but not the presence of HBV DNA. In a stratification analysis according to albumin levels of ≥3.5 g/dl, the presence of HBV DNA was a significant independent risk factor for the early-onset of HCC (OR 145.18, 95% CI 1.38-15296.61, P=0.036), whereas the presence of antibodies against hepatitis B core antigen was not found to be a risk factor. The presence of HBV DNA was not a risk factor for the early-onset of HCC in the overall analysis. However, its presence was an independent factor for the early-onset of HCC in HCV-infected patients with an albumin level of ≥3.5 g/dl. Thus, occult HBV infection may accelerate hepatocarcinogenesis in HCV-infected patients with relatively low carcinogenic potential.

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