Hepatitis B vs. hepatitis C infection on viral hepatitis-associated hepatocellular carcinoma
Hiotis SP et al. – Significant clinical–pathologic differences exist among hepatocellular carcinoma (HCC) patients with underlying hepatitis B virus (HBV) vs. hepatitis C virus (HCV). These differences impact eligibility for potentially–curative therapy and prognosis. Methods
- Patients presenting to a single urban hospital with a new diagnosis of HCC were entered into a clinical database.
- Variables including number and size of tumors, presence of metastases, serum alpha–Fetoprotein, hepatitis serologies, severity of hepatic dysfunction, and presence of cirrhosis were evaluated in 127 patients.
- Patients with hepatitis B (HBV) were more likely to develop HCC at a younger age than patients with hepatitis C (HCV) (HBV–26% under age 40, HCV–0% under age 40; p < 0.001), with greater serum alpha–Fetoprotein production (median level: HBV–1000 ng/ml vs. HCV– 37 ng/ml; p=0.002), with larger tumors (HBV–78% >5 cm, HCV–28% >5 cm; p < 0.001), in the absence of cirrhosis (HBV–40%, HCV–0%; p < 0.001), and a decreased eligibility for curative treatment (HBV–14%, HCV–34%; p < 0.05).
- Conversely, patients with HCV were more likely to develop HCC in association with multiple co–morbidities, cirrhosis, and older age.