Remote development of hepatocellular carcinoma in patients with liver cirrhosis type B serologically cured for HBs antigenemia with long-standing normalization of ALT values

Dig Dis Sci. 2002 Sep;47(9):2002-6. doi: 10.1023/a:1019608509402.

Abstract

In this report, we examine two patients with chronic hepatitis B virus (HBV) infection that had been diagnosed as precirrhosis or liver cirrhosis more than a decade previously. These patients had been cleared of HBsAg and had developed anti-HBs at a later time, yet hepatocellular carcinoma (HCC) eventually occurred. Both patients had been found negative for HBV DNA, using sensitive methods. Interestingly, a nontumor specimen of the liver obtained at surgical resection showed a marked reduction of fibrosis when compared to the histology observed when the patient was diagnosed as precirrhosis. Our findings suggest that the fibrosis from liver cirrhosis had been absorbed to a large extent during the long-term absence of active viremia and the normalization of alanine aminotransferase (ALT) levels. However, the cancer-prone biological characteristics of liver cirrhosis remained. Thus, patients with liver cirrhosis due to past chronic hepatitis B should be monitored carefully for the development of HCC even if HBV infection has been serologically resolved.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alanine Transaminase / blood*
  • Carcinoma, Hepatocellular / etiology*
  • Hepatitis B Antibodies / immunology
  • Hepatitis B, Chronic / complications*
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Neoplasms / etiology*
  • Male
  • Middle Aged
  • Time Factors

Substances

  • Hepatitis B Antibodies
  • Alanine Transaminase