Hepatitis B virus transmission and hepatocarcinogenesis: a 9 year retrospective cohort of 13676 relatives with hepatocellular carcinoma.
OBJECTIVE
Familial clustering of hepatitis B virus (HBV) infection is related to perinatal transmission, and is the main cause of familial-type hepatocellular carcinoma (HCC). The route of HBV transmission differs between the children and siblings of patients with HCC. This study examined the differences in HBV carrier rates and HCC-related mortality between two generations in HCC families.


METHODS
From 1992 to 1997, relatives of individuals with HCC were screened prospectively with ultrasonography, alpha-fetoprotein, liver biochemistry tests and viral markers. Total HCC-related deaths during a 9-year period were compared between the generations of index patients and their children.


RESULTS
The study included a total of 13676 relatives in two generations. More HCC-related deaths occurred in the index patient generation than in the child generation. Furthermore, children of female index patients had higher rates of liver cancer related mortality than children of male index patients. The same was true when the analysis was limited to male HBV carriers. The prevalence of HBsAg in the offspring of HBsAg positive mothers was 66% in the child generation and 72% in the index patient generation. These high prevalences indicated high maternal HBV replication status.


CONCLUSIONS
Perinatal transmission and maternal viral load are important risk factors in hepatocarcinogenesis.
Chen
Chien-Hung
CH
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
Chen
Yang Yuan
YY
Chen
Gran-Hum
GH
Yang
Sien-Sing
SS
Tang
Huang-Shang
HS
Lin
Hsien Hong
HH
Lin
Deng-Yn
DY
Lo
Sing Kai
SK
Du
Jeng-Ming
JM
Chang
Ting-Tsung
TT
Chen
Shinn-Cherng
SC
Liao
Li-Ying
LY
Kuo
Chung-Huang
CH
Lin
Kwo-Chuan
KC
Tai
Dar-In
DI
Changchien
Chi-Sin
CS
Chang
Wen-Yu
WY
Sheu
Jin-Chuan
JC
Chen
Ding-Shinn
DS
Liaw
Yun-Fan
YF
Sung
Juei-Low
JL
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000235:genetics* / Q000401:mortality; D002353:Carrier State; D015331:Cohort Studies; D018562:Disease Transmission, Infectious; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000235:genetics* / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008113:Liver Neoplasms / Q000209:etiology / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
D006514:Hepatitis B Surface Antigens