Occult HBV infection status and its impact on surgical outcomes in patients with curative resection for HCV-associated hepatocellular carcinoma

Background:We sought to clarify the prevalence of occult hepatitis B virus(HBV)infection(OBI)and to determine whether OBI affects the surgical outcomes in curatively resected Japanese patients with hepatitis C virus(HCV)-related hepatocellular carcinoma(HCC).Methods:A total of 257 patients with HCV-related HCC who underwent curative surgical resection were enrolled.All enrolled patients were serologically negative for HBV surface antigen and positive for HCV antibody.DNA was extracted from formalin-fixed paraffin-embedded liver tissue.OBI was determined by the HBV-DNA amplification of at least two different sets of primers by TaqMan real-time polymerase chain reaction.Surgical outcomes were evaluated according to overall survival(OS),disease-specific survival(DSS),and disease-free survival(DFS).Results:OBI was identified in 15 of the 257(5.8%)cases.In the multivariate analyses,the factors significantly correlated with OS were BMI>25(P=0.0416),portal vein invasion(P=0.0065),and multiple tumors(P=0.0064).The only factor significantly correlated with DSS was T-stage(P=0.0275).The factors significantly correlated with DFS were liver fibrosis(P=0.0017)and T-stage(P=0.0001).The status of OBI did not show any significant correlation with OS,DSS or DFS,but a weak association with DSS(P=0.0603)was observed.Conclusions:The prevalence of OBI was 5.8%in 257 cases of HCV-related HCC.Although a weak association between DSS and OBI was observed,and statistical analyses were limited by small number of OBI cases,no significant correlation between OBI and surgical outcomes was detected.