title: Analysis of risk factors for hepatocellular carcinoma that is negative for hepatitis B surface antigen (HBsAg).
abstract: OBJECTIVE
  To clarify risk factors for hepatocellular carcinoma (HCC) other than hepatitis B surface antigen (HBsAg).
  
  
  METHODS
  We investigated serum HBV-DNA and other factors in 146 patients with liver cirrhosis (LC) or HCC who were HBsAg negative. We analyzed the clinical background of the patients, status of hepatitis B (HBV) viral markers and platelet count as well as the presence of an HBV-DNA fragment by PCR and elucidated risk factors for HCC generation using a logistic regression model.
  
  
  RESULTS
  Among ten factors, we determined that four represented a significant risk for HBsAg negative HCC: male gender, total alcohol consumption, total cigarettes smoked, and the presence of an HBV-DNA fragment. Multivariate analysis showed that among the four factors, the HBV-DNA fragment was an independent factor associated with HCC.
  
  
  CONCLUSIONS
  The presence of an HBV-DNA fragment irrespective of the status of antibodies to either HBsAg (anti-HBs) or hepatitis B core antigen (anti-HBc) is a pivotal factor associated with the development of HCC.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University Aoto Hospital, Tokyo.
authors.forename: Seika
authors.initials: S
authors.lastname: Shimada
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Aizawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suto
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Miyakawa
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D001483:Base Sequence; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology / Q000821:virology*; D004247:DNA / Q000235:genetics; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000276:immunology / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D006514:Hepatitis B Surface Antigens; D004247:DNA