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Tang BQ , Kruger WD , Chen G , Shen FM , Lin WY , Mboup S , London WT , Evans AA
Hepatitis B viremia is associated with increased risk of hepatocellular carcinoma in chronic carriers
Journal of Medical Virology. 2004 Jan;72(1) :35-40
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Abstract
The role of quantitative viral load in development of hepatocellular carcinoma (HCC) among chronic hepatitis B virus (HBV) carriers was evaluated using real-time PCR (TaqMan PCR), a highly sensitive method for quantitative detection of HBV DNA. Serum samples collected at study entry from HCC cases and matched controls were chosen separately from ongoing prospective cohort studies in Senegal, West Africa, and Haimen City, China. For 14 HCC cases and 28 controls from Senegal, the relative risk (RR, 95% CI) of HCC was 15.6 (2.0-124.3) for those positive by the TaqMan PCR assay. Average length of follow-up (study entry to death from HCC) among cases was 2.8 (+/-1.6) years. The paired median difference between cases and controls was 3.8 x 10(4) virions/ml, with cases higher (P = 0.09). In order to clarify the relationship with lower-titer viremia, we selected 55 cases and 55 matched controls from the Chinese cohort all negative for serum HBV DNA by conventional dot blot hybridiza! tion. In this group, the RR associated with HBV DNA positivity by TaqMan PCR was 3.1 (1.1-9.2), with an average duration of follow-up of 3.3 (+/-2.1) years. The median difference in quantitative viremia between cases and controls was 6.0 x 10(4) virions/ml, with cases higher (P < 0.0001). Increased risk appeared to be confined to subjects with viral loads >2.3 x 10(4) virions/ml. In conclusion, HBV viremia, except perhaps at extremely low levels, is associated with increased risk for HCC in prospective studies of chronic carriers in two disparate populations.
Notes
English Article Evans, AA; *Fox* *Chase* Canc Ctr, 333 Coffman Ave, Philadelphia, PA 19111 USA. Research Addresses: *Fox* *Chase* Canc Ctr, Philadelphia, PA 19111 USA. Fudan Univ, Sch Publ Hlth, Shanghai 200433, Peoples R China. Haimen City Ctr Dis Control, Haimen, Peoples R China. Ctr Hosp Dantec, Dakar, Senegal. Cited References: DUFOUR DR, 2000, CLIN CHEM, V46, P2027 EVANS AA, 1998, CANCER EPIDEM BIOMAR, V7, P559 EVANS AA, 2002, CANCER EPIDEM BIOMAR, V11, P369 FATTOVICH G, 1986, HEPATOLOGY, V6, P167 FERET E, 1987, AM J EPIDEMIOL, V125, P140 HOLLINGER FB, 1996, FIELDS VIROLOGY, V2, P2738 HOOFNAGLE JH, 1987, HEPATOLOGY, V7, P758 LOEB KR, 2000, HEPATOLOGY, V32, P626 LOK ASF, 2001, HEPATOLOGY, V34, P1225 MARINIER E, 1985, J PEDIATR, V106, P843 MCMAHON BJ, 2001, ANN INTERN MED, V135, P759 STEVENS CE, 1979, J MED VIROL, V3, P237 WHITTLE H, 1990, J INFECT DIS, V161, P1112 YANG HI, 2002, NEW ENGL J MED, V347, P168 Number of cited references: 14 Number of times cited: 0 Publisher: WILEY-LISS; DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA. 0146-6615