studies

1112A AASLD ABSTRACTS HEPATOLOGY, October, 2015
1850
Prevalence of hepatitis B core antibody (anti-HBc) and
association with hepatocellular carcinoma (HCC) in
patients with chronic hepatitis C virus (HCV) infection in
the United States (US) and China
Ming Yang 1 , Elizabeth Wu 2 , Sherry Fu 2 , Huiying Rao 1 , Bo Feng 1 ,
Andy Lin 3 , Ran Fei 1 , Neehar D. Parikh 2 , Robert J. Fontana 2 , Anna
S. Lok 2 , Lai Wei 1 ; 1 Peking University People’s Hospital, Peking
University Hepatology Institute, Peking University Health Science
Center, Beijing, China; 2 Division of Gastroenterology, University
of Michigan Health System, Ann Arbor, MI; 3 The Molecular and
Behavioral Neuroscience Institute, University of Michigan, Ann
Arbor, MI
Background: Evidence of previous hepatitis B virus (HBV) infection
[i.e. detectable anti-HBc with undetectable hepatitis B
surface antigen (HBsAg)] has been associated with increased
risk of HCC in patients with chronic HCV infection in many
Asian studies but this was not confirmed in some studies in the
US. Aims: To compare the prevalence of anti-HBc between US
and Chinese patients with chronic HCV and identify clinical
correlates of anti-HBc positivity. Methods: Prospective study
of 2 cohorts of chronic HCV patients at University of Michigan
in Ann Arbor, US and Peking University People’s Hospital
in urban Beijing and Gu’an and Kuancheng Clinics in rural
Hebei, China. Results: A total of 1,833 patients were analyzed
(963 US; 870 Chinese). 32.3% of US and 46.6% of
Chinese HCV patients were anti-HBc+ and HBsAg- (p0.001).
The prevalence of anti-HBc among patients with chronic hepatitis,
cirrhosis, and HCC was 30.5%, 32.3% and 38.5% in
the US (p=0.250) and 44.5%, 53.8% and 66.7% in China
(p=0.020), respectively. Anti-HBc+ patients were older, had
longer estimated duration of infection and were more likely to
have a history of alcohol and tobacco use in both cohorts. US
anti-HBc+ patients were more likely to be men and to report
a history of injection drug use as the source of infection. In
contrast, Chinese anti-HBc+ patients were more likely to report
medical procedures as the source of infection. Multivariate
analysis showed that there was no association between anti-
HBc positivity and HCC in the US and Chinese cohorts and the
combined cohort. Conclusions: Evidence of previous HBV infection
among patients with chronic HCV is lower in the US cohort
compared to the Chinese cohort. Although the prevalence of
anti-HBc paralleled the severity of HCV-related liver disease,
anti-HBc positivity was not an independent factor associated
with risk of HCC in patients with chronic HCV in both US and
Chinese cohorts.
Characteristics of Patients with and without anti-HBc in the US
and China
Anna S. Lok - Advisory Committees or Review Panels: Gilead, MYR, Tekmira;
Consulting: GSK, Merck; Grant/Research Support: AbbVie, BMS, Gilead, Idenix
Lai Wei - Advisory Committees or Review Panels: Gilead, AbbVie; Grant/
Research Support: BMS
The following authors have nothing to disclose: Ming Yang, Elizabeth Wu, Sherry
Fu, Huiying Rao, Bo Feng, Andy Lin, Ran Fei, Neehar D. Parikh
1851
Wisteria floribunda agglutinin-positive Mac-2-binding
protein predicts hepatocellular carcinoma development
in chronic hepatitis C patients who achieved sustained
virological response to interferon-based anti-viral therapy
Shunsuke Sato, Hironori Tsuzura, Takuya Genda, Akihito Nagahara;
Gastroenterology and Hepatology, Juntendo University Shizuoka
Hospital, Izunokuni, Japan
Objective: The achievement of a sustained virological response
(SVR) after anti-viral therapy reduces the incidence of hepatocellular
carcinoma (HCC) development in patients with chronic
hepatitis C. In advances of direct acting antivirals against hepatitis
C virus, it is expected to drastically increase the patients
with achievement of SVR. However, HCC development in
patients who achieved SVR is not rarely observed. Liver fibrosis
is known as a predictor of HCC development in patients with
achievement of SVR. Although several noninvasive methods
evaluating liver fibrosis has been reported, wisteria floribunda
agglutinin (WFA)-positive Mac-2-binding protein (WFA + -M2BP)
is recently developed as a noninvasive glycobiomarker of liver
fibrosis. The aim of this study is to evaluate WFA + -M2BP as
a predictive marker of HCC development in chronic hepatitis
C patients with achievement of SVR. Methods: A total 280
patients who achieved SVR by interferon-based anti-viral therapy
and underwent measurement of serum WFA + -M2BP level
were enrolled. We compared its usefulness as a predictive
marker of HCC development to other risk factors including age,
gender, body mass index, fibrosis stage, aspartate aminotransferase,
alanine aminotransferase, gamma-glutamyl transpeptidase,
and alpha-fetoprotein (AFP) by using multivariate Cox
proportional hazard analysis. Cumulative incidences of HCC
development were evaluated using Kaplan-Meier plot analysis
and the log-rank test. Results: Serum WFA + -M2BP level was significantly
correlated with liver fibrosis stage (p=0.001). During
the median follow-up time of 4.0 years, 9 of the 280 patients
developed HCC. Multivariate cox proportional hazard analysis
revealed that WFA + -M2BP level was an independent risk factor
of HCC development (hazard ratio (HR): 1.167, 95% confidence
interval (CI): 1.015-1.342, p=0.030) as well as platelet
counts (HR: 0.682, 95%CI: 0.538-0.864, p