Morphology of cirrhosis and occurrence of hepatocellular carcinoma in alcoholics with and without HBsAg and in non-alcoholic HBsAg-positive patients. A comparative autopsy study.

The morphology of liver cirrhosis and the incidence of hepatocellular carcinoma (HCC) in HBsAg-positive alcoholics (17 cases) were examined and compared with those of HBsAg-negative alcoholics (31 cases) and HBsAg-positive non-alcoholics (59 cases). These materials were obtained from our autopsy cases during the last 9 years. About 70% of the 17 showed macronodular cirrhosis, in which periportal and portal lymphoid cell infiltration and liver cell dysplasia were often present, as seen in HBsAg positive non-alcoholics. Furthermore, the liver weight and age distribution at autopsy in HBsAg-positive alcoholics were similar to those of HBsAg-positive non-alcoholics and different from those of HBsAg-negative alcoholics. The association rate of HCC was very high in HBsAg-positive alcoholics (64.7%), similar to that in HBsAg-positive non-alcoholics (67.8%), while the rate in HBsAg-negative alcoholics was low (22.6%). It therefore seems likely that in HBsAg-positive alcoholics concomitant HB virus infection has a major effect on the development of cirrhosis, especially a macronodular type, and on HCC formation.