Hepatitis B virus-related hepatocellular carcinogenesis and its prevention.
To elucidate the influence of serum hepatitis B virus (HBV) load on hepatocellular carcinogenesis in cirrhotic patients, HBV-DNA was sequentially measured. In a nested, case-control study using 96 patients without antiviral therapy, high HBV-DNA (> or =10(3.7) copies/ml) in the last 3 years was significantly associated with carcinogenesis (a patient group without hepatocellular carcinoma (HCC) development; 0/48 vs. a patient group with eventual HCC development; 22/48, p < 0.0001). No patient with a continuously low HBV-DNA for the last 3 years developed HCC. Persistence of high HBV-DNA concentration suggested an increased risk of carcinogenesis. In a retrospective cohort study using 57 patients with interferon therapy, HCC developed in 2 (8.0%) of the 25 patients with HBV-DNA loss, while carcinogenesis was found in 11 (34.4%) of 32 patients without HBV-DNA loss (Fisher's exact test, p = 0.026). A significant decrease or loss of serum HBV-DNA stops HCC development, and its sequential analysis could be very useful both in the prediction and early detection of small HCC.
Ikeda
Kenji
K
Department of Gastroenterology, Toranomon Hospital, Tokyo, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan. ikedakenji@tora.email.ne.jp
Arase
Yasuji
Y
Kobayashi
Masahiro
M
Someya
Takashi
T
Hosaka
Tetsuya
T
Saitoh
Satoshi
S
Sezaki
Hitomi
H
Akuta
Norio
N
Suzuki
Fumitaka
F
Suzuki
Yoshiyuki
Y
Kumada
Hiromitsu
H
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000517:prevention & control*; D016022:Case-Control Studies; D004279:DNA, Viral / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications / Q000821:virology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D019562:Viral Load
D004279:DNA, Viral; D007372:Interferons