title: Consistently low hepatitis B virus DNA saves patients from hepatocellular carcinogenesis in HBV-related cirrhosis. A nested case-control study using 96 untreated patients.
abstract: BACKGROUND
  To elucidate the influence of serum hepatitis B virus (HBV) load on hepatocellular carcinogenesis in cirrhotic patients, HBV-DNA was sequentially measured.
  
  
  METHODS
  Among 160 consecutive patients with HBV-related cirrhosis who received no anti-viral therapy, serial assay of HBV-DNA concentration was available in 146 (91.3%): 48 developed hepatocellular carcinoma (HCC) and 98 did not during a median of 11.7 years. HBV-DNA of 10(3.7) copies/ml or less was considered as low.
  
  
  RESULTS
  Of the 48 cases with eventual HCC development (group A), 9 showed intermittently high HBV-DNA, and the other 39 persistently high values. Among 48 age- and sex-matched control patients (group B) selected from the 98 HCC-free patients, 9 had continuously low HBV-DNA, 13 showed a settled down course of HBV-DNA, 9 intermittently high, and the remaining 17 patients demonstrated continuously high HBV-DNA. High HBV-DNA in the last 3 years was significantly associated with carcinogenesis (group A; 0/48 vs. group B; 22/48, p < 0.0001). No patient with a continuously low HBV-DNA for the last 3 years developed HCC.
  
  
  CONCLUSIONS
  Persistence of high HBV-DNA concentration suggested an increased risk of carcinogenesis. Sequential analysis of HBV-DNA is important in the assessment of the carcinogenesis risk.
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan. ikedakenji@tora.email.ne.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikeda
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Arase
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Someya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saitoh
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Suzuki
authors.forename: Akihito
authors.initials: A
authors.lastname: Tsubota
authors.forename: Norio
authors.initials: N
authors.lastname: Akuta
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000517:prevention & control*; D016022:Case-Control Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000821:virology*; D006515:Hepatitis B virus / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000821:virology*; D008113:Liver Neoplasms / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors
chemical_list: D004279:DNA, Viral