According to a study published in the journal Cancer, the presence of occult hepatitis B infection increases the risk of liver cancer in patients with chronic hepatitis. Occult hepatitis B infection refers to an infection in which there is evidence of the virus in the patient’s liver, but the patient tests negative for hepatitis B surface antigen (HBsAg).
The liver is the largest organ in the body and is responsible for over 500 functions. These include the secretion of glucose, proteins, vitamins, and fats; the production of bile; the processing of hemoglobin; and the detoxification of numerous substances.
The most common type of liver cancer, hepatocellular carcinoma (HCC), is characterized by cancer that starts in cells of the liver and can spread through blood and lymph vessels to different parts of the body.
Infection with hepatitis B virus and/or hepatitis C virus is the most important cause of HCC, particularly in patients with chronic active hepatitis.
Serologic (blood serum) testing for hepatitis B surface antigen (HBsAg) is used to identify patients with acute or chronic hepatitis B infection. Some patients, however, have “occult” hepatitis B infection, meaning that they test negative for HBsAg but have evidence of hepatitis B virus in their liver. Occult hepatitis B infections are thought to be common among patients with HBsAg-negative chronic liver disease.
To assess the role of occult hepatitis B infection in the development of HCC, researchers in Italy conducted a study among 134 HBsAg-negative patients with chronic hepatitis. All but 10 of these patients tested positive for the hepatitis C virus. Patients were followed for a median of four years.
- Fifty-three of the patients (39%) had occult hepatitis B infections and 81 (61%) did not.
- Nine patients developed HCC, and all except for one was positive for occult hepatitis B infection.
The researchers conclude that identification of occult hepatitis B infections in patients with chronic hepatitis may identify patients at greater risk of developing HCC.
Reference: Squadrito G, Pollicino T, Cacciola I et al. Occult Hepatitis B Virus Infection is Associated with the Development of Hepatocellular Carcinoma in Chronic Hepatitis C Patients. Cancer. 2006;106:1326-30.