Elsevier

Journal of Hepatology

Volume 29, Issue 2, August 1998, Pages 173-183
Journal of Hepatology

Impact of HBV, HCV and GBV-C/HGV on hepatocellular carcinomas in Europe: results of a European concerted action

https://doi.org/10.1016/S0168-8278(98)80001-9Get rights and content

Abstract

Background/Aims: To investigate the impact of hepatitis B (HBV) and C (HCV) infections on hepatocellular carcinoma (HCC) in Europe.

Methods: Five hundred and three patients with HCC, from six liver centers, were included. All 503 sera and 80 liver samples were tested for HBV DNA and HCV RNA by polymerase chain reaction. GBV-C/HGV RNA was also tested in 57 sera.

Results: HBsAg and anti-HCV were detected in 19% and 40.1% of the patients, respectively. Serum and liver HBV DNA were detected in 82% and 91% of the HBsAg positive subjects. HBV DNA was also detected in the serum and liver of 33% and 47% of HBsAg negative patients. In this group, serum HBV DNA was more prevalent in anti-HBs and/or anti-HBc patients (47.9%), compared to those without any HBV marker (25.1%). HCV RNA was detected in 89% and 7% of anti-HCV positive and negative cases, respectively, HCV 1b being the most prevalent genotype (80%). Coinfection with HBV and HCV was shown in 20.4% of patients, while only 29% had neither HBV nor HCV. GBV-C/HGV RNA was detected in only 457 sera.

Conclusions: This study offers the first large analysis of HCC in Europe, based on both serology and molecular tests. It demonstrates the major impact of HBV and HCV, but not of GBV-C/HGV, in liver carcinogenesis in Northern as well as Southern Europe. It also stresses the need to use viral genome detection in epidemiological studies when serological tests are negative.

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      The development of sensitive assays to detect small amounts of HBV DNA has favored the identification of occult hepatitis B infection, which is characterized by undetectable HBsAg in serum and HBV DNA detectable in the liver tissue.11 In patients with chronic hepatitis C, occult HBV infection was found to be associated with more severe liver damage,12,13 a higher risk of developing HCC14–19 and HBV reactivation in immunosuppressed patients,20,21 such as onco-hematological patients receiving chemotherapy.22 This virological condition has been more frequently found in patients with serological markers of previous HBV infection (anti-HBc, anti-HBs) than in those without.23

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