背景和目的：以往的研究表明先前的乙肝病毒感染的暴露因素可能增加慢性丙型肝炎患者发展成为肝癌的危险。这项研究的目的是比较一群乙肝表面抗原阴性的组织学上为晚期慢性丙肝的发展或没发展成为肝癌的美国患者既往乙肝感染或隐性乙肝感染的患病率。方法：来自91位肝癌患者和182位与之搭配的接受HALT-C治疗的对照者的血清用来检测抗-HBc，抗-HBs和HBV DNA。来自28个肝癌病例和55个对照者的冷冻肝脏样本通过实时-PCR用来检测HBV DNA。结果：抗-HBc（作为既往HBV感染的标志）出现在41.8%的肝癌患者和45.6%的对照组血清中（P=0.54）；抗-HBc单独出现在16.5%的肝癌患者和24.7%的对照组身上。HBVDNA仅在一位对照组受试者的血清中探测到，肝癌患者未探测到。HBV DNA（作为乙肝隐性感染的标志）在10.7%的肝癌患者的肝脏标本中探测到，在23.6%的对照组肝脏标本中探测到。结论：虽然几乎半数的接受HALT-C的患者有乙肝既往感染的血清学证据，但是抗-HBc在血清或HBV DNA在肝组织的出现率在发展或没发展成为肝癌的患者之间没有区别。在美国，既不是乙肝既往感染又不是乙肝隐性感染是一个晚期慢性丙肝患者发展成为肝癌的重要因素。

Background and aim：Previous studies have suggested that prior exposure to hepatitis B virus(HBV) infection may increase the risk of development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C. The aim of this study was to compare the prevalence of previous or occult HBV infection in a cohort of HBsAg-negative patients with histologically advanced chronic hepatitis C in the United States who did or did not develop HCC. Methods： Stored sera from 91 patients with HCC and 182 matched controls who participated in the HALT-C Trial were tested for anti-HBc, anti-HBs and HBV DNA. Frozen liver samples from 28 HCC cases and 55 controls were tested for HBV DNA by real-time PCR. Results：Anti-HBc (as a marker of previous HBV infection) was present in the serum of 41.8% HCC cases and 45.6% controls (P=0.54); anti-HBc alone was present in 16.5% of HCC cases and 24.7% of controls. HBV DNA was detected in the serum of only one control subject and no patient with HCC. HBV DNA (as a marker of occult HBV infection) was detected in the liver of 10.7% HCC cases and 23.6% controls (P=0.18).Conclusion Although almost half the patients in the HALT-C Trial had serological evidence of previous HBV infection there was no difference in prevalence of anti-HBc in serum or HBV DNA in liver between patients who did or did not develop HCC. In the United States,neither previous nor occult HBV infection is an important factor in HCC development among patients with advanced chronic hepatitis C.