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Positive Hepatitis B Core Antibody Is Associated With Cirrhosis and Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease.
Chan, Ting Ting; Chan, Wah Kheong; Wong, Grace Lai-Hung; Chan, Anthony Wing-Hung; Nik Mustapha, Nik Raihan; Chan, Stephen Lam; Chong, Charing Ching-Ning; Mahadeva, Sanjiv; Shu, Sally She-Ting; Lai, Paul Bo-San; Chan, Henry Lik-Yuen; Wong, Vincent Wai-Sun.
Afiliación
  • Chan TT; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
  • Chan WK; Gastroenterology and Hepatology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
  • Wong GL; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
  • Chan AW; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
  • Nik Mustapha NR; Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China.
  • Chan SL; Department of Pathology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
  • Chong CC; Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
  • Mahadeva S; Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
  • Shu SS; Gastroenterology and Hepatology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
  • Lai PB; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
  • Chan HL; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
  • Wong VW; Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Am J Gastroenterol ; 115(6): 867-875, 2020 06.
Article en En | MEDLINE | ID: mdl-32149781
OBJECTIVES: Previous exposure to hepatitis B virus (HBV) may increase the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C. We aim to study the impact of previous HBV infection on the severity and outcomes of patients with nonalcoholic fatty liver disease (NAFLD). METHODS: This was a multicenter study of 489 patients with biopsy-proven NAFLD and 69 patients with NAFLD-related or cryptogenic HCC. Antihepatitis B core antibody (anti-HBc) was used to detect the previous HBV infection. RESULTS: In the biopsy cohort, positive anti-HBc was associated with lower steatosis grade but higher fibrosis stage. 18.8% and 7.5% of patients with positive and negative anti-HBc had cirrhosis, respectively (P < 0.001). The association between anti-HBc and cirrhosis remained significant after adjusting for age and metabolic factors (adjusted odds ratio 2.232; 95% confidence interval, 1.202-4.147). At a mean follow-up of 6.2 years, patients with positive anti-HBc had a higher incidence of HCC or cirrhotic complications (6.5% vs 2.2%; P = 0.039). Among patients with NAFLD-related or cryptogenic HCC, 73.9% had positive anti-HBc. None of the patients had positive serum HBV DNA. By contrast, antihepatitis B surface antibody did not correlate with histological severity. DISCUSSION: Positive anti-HBc is associated with cirrhosis and possibly HCC and cirrhotic complications in patients with NAFLD. Because a significant proportion of NAFLD-related HCC may develop in noncirrhotic patients, future studies should define the role of anti-HBc in selecting noncirrhotic patients with NAFLD for HCC surveillance.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Enfermedad del Hígado Graso no Alcohólico / Hepatitis B / Anticuerpos contra la Hepatitis B / Antígenos del Núcleo de la Hepatitis B / Cirrosis Hepática / Neoplasias Hepáticas Tipo de estudio: Clinical_trials / Etiology_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Am J Gastroenterol Año: 2020 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Enfermedad del Hígado Graso no Alcohólico / Hepatitis B / Anticuerpos contra la Hepatitis B / Antígenos del Núcleo de la Hepatitis B / Cirrosis Hepática / Neoplasias Hepáticas Tipo de estudio: Clinical_trials / Etiology_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Am J Gastroenterol Año: 2020 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos