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

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Abstract
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 nonalcoholics (59 cases). These materials were obtained from autopsy cases during the last 9 yr. 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 nonalcoholics. Furthermore, the liver weight and age distribution at autopsy in HBsAg-positive alcoholics were similar to those of HBsAg-positive nonalcoholics and different from those of HBsAg-negative alcoholics. The association rate of HCC was very high in HBsAg-positive alcoholics (64.7%), similiar to that in HBsAg-positive nonalcoholics (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.