title: High viral load is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis B virus infection.
abstract: OBJECTIVE
  Hepatitis B virus (HBV) is considered a major risk factor for the progression to liver cirrhosis and hepatocellular carcinoma (HCC). The serum level of HBV-DNA is correlated with progression of the disease. The aim of the present study was to determine the relationship between the level of HBV-DNA and hepatocarcinogenesis in patients with chronic HBV infection.
  
  
  METHODS
  The authors studied 73 patients who were diagnosed with chronic HBV infection at Nagasaki University Hospital (Nagasaki, Japan) between January 1980 and December 1999. The significance of age, sex, habitual drinking, serum alanine aminotransferase level, HBV viral load, interferon treatment, hepatic fibrosis and hepatic inflammation on the development of HCC were examined using univariate and multivariate analyses.
  
  
  RESULTS
  The cumulative incidence rates of HCC were 14%, 29% and 48% at 5, 10 and 15 years after liver biopsy, respectively. Multivariate analysis identified high viral load, together with age and severe fibrosis, as independent and significant risk factors (P = 0.045, 0.047 and 0.013, respectively) for HCC.
  
  
  CONCLUSIONS
  The present findings indicate that high viral load is a risk factor for HCC in patients with chronic HBV infection. Patients with a high HBV viral load should be carefully monitored for HCC.
authors.affiliation: First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan. oohata-gi@umin.ac.jp
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ohata
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hamasaki
authors.forename: Kan
authors.initials: K
authors.lastname: Toriyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000821:virology*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D019562:Viral Load