Cirrhosis Is Present in Most Patients With Hepatitis B and Hepatocellular Carcinoma

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http://www.cghjournal.org/article/PIIS1542356510008487/abstract?rss=yes

Clinical Gastroenterology and Hepatology

Volume 9, Issue 1 , Pages 64-70, January 2011

Cirrhosis Is Present in Most Patients With Hepatitis B and Hepatocellular

Carcinoma

published online 09 September 2010.

Abstract

Background & Aims

There are few data available about the prevalence or effects of cirrhosis in

patients with hepatocellular carcinoma (HCC) from viral hepatitis. We compared

patients with HCC and hepatitis B virus (HBV) or hepatitis C virus (HCV)

infections to determine the proportions of cirrhosis in each group, virologic

and tumor characteristics, and overall survival.

Methods

This analysis included patients with HBV (n = 64) or HCV (n = 118) infection who

were diagnosed with HCC at the Mayo Clinic in Rochester, Minnesota from

1994–2008; groups were matched for age and sex. The diagnosis of cirrhosis was

based on histology and, if histologic information was insufficient or

unavailable, clinical indicators that included ascites or varices,

thrombocytopenia or splenomegaly, and radiographic configuration of cirrhosis.

Virologic characteristics, tumor stage, and patient survival were also assessed.

Results

The prevalence of histologic cirrhosis was 88% among patients with HBV infection

and 93% among those with HCV infection (P = .46). When the most inclusive

criteria for cirrhosis were applied, cirrhosis was present in 94% of patients

with HBV and 97% with HCV (P = .24). Among HCV patients, 5.2% were negative for

HCV RNA after antiviral treatment; 63.4% of HBV patients had HBV DNA <2000 IU/mL

with or without treatment. Patients with HBV tended to have less surveillance

and more advanced stages of HCC, without differences in survival from those with

HCV infection (P = .75).

Conclusions

Most patients with HCC and chronic viral hepatitis had evidence of cirrhosis,

including those with HBV infection and those without active viral replication.

Conflicts of interest The authors disclose no conflicts.

Funding This study was supported by grants from the National Institute of

Diabetes and Digestive and Kidney Diseases (DK-34238).

PII: S1542-3565(10)00848-7

doi:10.1016/j.cgh.2010.08.019

© 2011 AGA Institute. Published by Elsevier Inc. All rights reserved