HBV-negative Patients Research Articles

Association between HCV and HBV infection in hepatocellular carcinoma and alcoholic liver disease

We conducted a retrospective study in 229 patients to determine the prevalence of hepatitis C virus (HCV) according to the type of liver disease and also the serum hepatitis B virus (HBV) status. There were 55 cases of hepatocellular carcinoma (HCC), 78 cases of alcoholic cirrhosis (AC) and 96 cases of non-cirrhotic alcohol liver disease (NCA). Half the AC and NCA groups were constituted of patients with or without serum HBV markers. The prevalence of anti-HCV antibodies in HCC (58.2%) was significantly higher than in the other groups (AC, 35.9%; NCA, 17.7%). Combining the two AC and NCA groups gave a 25.8% anti-HCV prevalence in the alcoholics. Altogether anti-HCV antibodies were more frequently present in HBV-positive than in HBV-negative patients (42.2 vs. 26.1%, p < 0.01), although the difference was not significant when the HCC group was separately analysed. The S N ratio of anti-HCV-positive samples varied according to the type of the disease (tumorous vs. non-tumorous) and to the serum HBV status. Indeed, 65.6% of HCC had a S N > 4 compared to only 32.2 and 23.5% in AC and NCA, respectively ( p < 0.01). On the other hand more than half of the AC and NCA had a S N < 2 , indicating possible artefacts in certain cases. The 15 HBsAg and anti-HCV-positive patients had a significantly lower mean S N than patients displaying only antibodies against HBV, even in the HCC group. Our data obtained from a large group of patients having HCC and/or alcoholic liver disease show that the prevalence of anti-HCV in these populations increases with the severity of hepatic injury. Furthermore, variations appear in the S N ratio according both to the type of the disease and the serum HBV status.

Relationship between HBV markers and heroin as a cause of liver injury in drug addicts

Fifty liver biopsies from heroin addicts on methadone maintenance were studied for histological features. The relationship between hepatic damage, HBV markers and the length of drug abuse was analysed. Infiltration was found in 95.6% of hepatitis B surface antigen (HBsAg) positive patients and in 50% of hepatitis B surface antibody (HBsAb) positive and HBV negative patients. The length of drug abuse showed a strong direct correlation with vacuolar degeneration ( P < 0.001) and an inverse correlation with fibrosis ( P < 0.05).

Gastrointestinal endoscopy and HBV infection: no evidence for a causal relationship: A prospective controlled study

The importance of the different endoscopic procedures in the transmission of hepatitis B was investigated prospectively by following up for 6 months all HBV-negative patients endoscoped from April to October 1981. A group of patients admitted in the same period to our unit constituted the control group. Controls were obtained after 1, 3, and 6 months from endoscopy. Infection rate was 1% for the control group and 0.45% for the endoscopy group. The difference is not statistically significant. These results strongly support the view, already present on an uncontrolled basis in the literature, that transmission of hepatitis B is not associated with gastrointestinal endoscopy.

The course of chronic persistent hepatitis.

Twenty-nine patients with histologically diagnosed chronic persistent hepatitis were followed for a mean of 27 months. Twelve patients had evidence of HBV infection. All patients had repeat liver biopsies; in 18 the changes of chronic persistent hepatitis remained, 8 patients had minor changes, 2 patients showed apparent healing, whilst one patient progressed to chronic active hepatitis. Six of 7 non drug abusing HBV negative patients showed improvement on repeat liver biopsy whereas 15 of 20’ intravenous drug abusers and 9 of 12 HBV infected patients had not improved. All patients except one remained clinically well. Stigmata of chronic liver disease were infrequent and mild.