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. 2021 Jan-Dec:28:10732748211039758.
doi: 10.1177/10732748211039758.

Effects of Positive Hepatitis B Core Antibody and Metabolic Disorders in Hepatocellular Carcinoma in an Endemic Area of Hepatitis B Virus

Hae Lim Lee  1   2 , Si Hyun Bae  1   2 , Jaejun Lee  1   2 , Pil Soo Sung  1   2 , Sung Won Lee  1   2 , Jeong Won Jang  1   2 , Jungmin Lee  1 , Jong Young Choi  1   2 , Nam Ik Han  1   2 , Seung Kew Yoon  1   2
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Effects of Positive Hepatitis B Core Antibody and Metabolic Disorders in Hepatocellular Carcinoma in an Endemic Area of Hepatitis B Virus

Hae Lim Lee et al. Cancer Control. 2021 Jan-Dec.

Abstract

Background and aims: This retrospective study aimed to investigate the impact of positive hepatitis B core antibody (anti-HBc) and metabolic disorders on clinical characteristics of hepatocellular carcinoma (HCC) patients in an HBV-endemic area.

Methods: A total of 1950 consecutive patients newly diagnosed with HCC between 2002 and 2015 were included. Patient records were reviewed. We compared non-viral and non-alcoholic HCC patients with other etiological groups for HCC. In addition, we compared HCC patients with negative hepatitis B surface antigen (HBsAg) and positive anti-HBc to those with negative HBsAg and negative anti-HBc, and to those with HBV.

Results: The prevalence of non-viral and non-alcoholic HCC increased from 7% in 2002-2011 to 12% in 2012-2015. The proportion of non-viral and non-alcoholic HCC gradually increased with age. Patients with non-viral and non-alcoholic HCC exhibited higher rates of metabolic disorders and preserved liver function. The rate of anti-HBc positivity was similarly high in all HCC etiological groups. The clinical features of HCC patients with negative HBsAg and positive anti-HBc were similar to those with negative HBsAg and negative anti-HBc, but significantly different from those with HBV HCC. Regarding tumor characteristics, patients in the non-viral and non-alcoholic HCC group had more advanced stages of tumors (mUICC stage III-V and BCLC stage C/D). There was no significant difference in overall survival among the patient groups. The presence of anti-HBc did not affect patient survival.

Conclusion: Patients with non-viral and non-alcoholic HCC had a relatively high prevalence of metabolic disorders and preserved liver function. However, they had advanced tumor stage compared to patients from other etiological groups. Anti-HBc positivity did not affect the clinical characteristics or prognosis of non-HBV HCC patients in this study.

Keywords: anti–hepatitis B core antibody; cryptogenic hepatocellular carcinoma; hepatitis B virus; hepatocellular carcinoma; metabolic disease.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The proportion of HCC etiologies. (a) Etiologies of total HCC patients. (b) Change in composition ratio of HCC etiologies according to time. (c) Change in proportion of non-viral and non-alcoholic HCC according to age group. The proportion of non-viral and non-alcoholic and HCV-related HCC increased with age, while the proportion of HBV- and alcohol-related HCC was highest before 50s and in the 50s, respectively.
Figure 2.
Figure 2.
Kaplan–Meier curves of overall survival according to etiological group of HCC.
See this image and copyright information in PMC

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