title: Hepatitis B virus transmission and hepatocarcinogenesis: a 9 year retrospective cohort of 13676 relatives with hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Yang Yuan
authors.initials: YY
authors.lastname: Chen
authors.forename: Gran-Hum
authors.initials: GH
authors.lastname: Chen
authors.forename: Sien-Sing
authors.initials: SS
authors.lastname: Yang
authors.forename: Huang-Shang
authors.initials: HS
authors.lastname: Tang
authors.forename: Hsien Hong
authors.initials: HH
authors.lastname: Lin
authors.forename: Deng-Yn
authors.initials: DY
authors.lastname: Lin
authors.forename: Sing Kai
authors.initials: SK
authors.lastname: Lo
authors.forename: Jeng-Ming
authors.initials: JM
authors.lastname: Du
authors.forename: Ting-Tsung
authors.initials: TT
authors.lastname: Chang
authors.forename: Shinn-Cherng
authors.initials: SC
authors.lastname: Chen
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Liao
authors.forename: Chung-Huang
authors.initials: CH
authors.lastname: Kuo
authors.forename: Kwo-Chuan
authors.initials: KC
authors.lastname: Lin
authors.forename: Dar-In
authors.initials: DI
authors.lastname: Tai
authors.forename: Chi-Sin
authors.initials: CS
authors.lastname: Changchien
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Chang
authors.forename: Jin-Chuan
authors.initials: JC
authors.lastname: Sheu
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
authors.forename: Yun-Fan
authors.initials: YF
authors.lastname: Liaw
authors.forename: Juei-Low
authors.initials: JL
authors.lastname: Sung
mesh_terms: 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
chemical_list: D006514:Hepatitis B Surface Antigens