Consistently low hepatitis B virus DNA saves patients from hepatocellular carcinogenesis in HBV-related cirrhosis. A nested case-control study using 96 untreated patients.
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.
Ikeda
Kenji
K
Department of Gastroenterology, Toranomon Hospital, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan. ikedakenji@tora.email.ne.jp
Arase
Yasuji
Y
Kobayashi
Masahiro
M
Someya
Takashi
T
Saitoh
Satoshi
S
Suzuki
Yoshiyuki
Y
Suzuki
Fumitaka
F
Tsubota
Akihito
A
Akuta
Norio
N
Kumada
Hiromitsu
H
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
D004279:DNA, Viral