| Background: The combination of chronic hepatitis B virus (HBV) infectionand alcohol induced liver injury may accelerate progression to cirrhosis. Whetherthe same is true for alcoholic patients who have recovered from a previous HBVinfection or those with occult HBV infection, remains to be determined.Objectives: In the present study we investigated whether patients withalcoholic cirrhosis who test negative for hepatitis B surface antigen (HBsAg) butpositive for antibody to hepatitis B core antigen (anti-HBc) have more severe liverdisease than those who test negative for anti-HBc. Methods: A total of254HBsAg negative patients with alcoholic cirrhosis were identified and divided intoanti-HBc positive (N=171) and negative (N=83) cohorts. Demographic, clinical andbiochemical features of patients were retrospectively analyzed. Prognostic scoresand the prevalence of patients at high-risk for short-term mortality were calculatedand compared. Logistic regression was used to identify factors associated with a highrisk of short-term mortality.Results: The prevalence of jaundice (32.2%vs18.1%, P=0.02) was morecommon in the anti-HBc cohort. This cohort also had higher total serum bilirubin(70.9vs50.4, P=0.03), prothrombin times (15.6vs14.4, P=0.01), MELD (8.5vs4.6,P=0.01), i-MELD (28.6vs24.7, P=0.03), MDF (14.2vs6.8, P=0.02) and ABIC (7.2vs6.6, P=0.01) scores. In addition, anti-HBc positive patients were more often athigh risk for short-term mortality (40.4%vs26.5%, P=0.03). Multivariate analysisdemonstrated anti-HBc positivity (OR:1.84;95%CI:1.00-3.36) and alcohol intake≥150g/day (OR:2.01;95%CI:1.10-3.66) as independent risk factors for high riskmortality. Conclusion: Anti-HBc positivity is associated with severe hepatic damage inHBsAg negative patients with alcoholic cirrhosis. A prospective study includingHBV-DNA testing and liver biopsies should be considered to validate and furtherelucidate these findings. |
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