Role of hepatitis B viral load and basal core promoter mutation in hepatocellular carcinoma in hepatitis B carriers.
BACKGROUND
Several hepatitis B viral factors correlate with the progression of chronic liver disease. However, the independent and interactive effects of each known viral factor on the development of hepatocellular carcinoma (HCC) remain largely unknown.


METHODS
In a cross-sectional, retrospective, hospital-based setting, we comprehensively compared viral factors in 160 chronic hepatitis B virus (HBV) carriers and 200 patients with HCC, to clarify the independent and joint effect of each factor.


RESULTS
In univariate analysis, statistically significant odds ratios (ORs) were obtained for male sex (P < .001), advanced age (P < .001), HBV genotype C infection (P = .005), the precore A1896 mutation (P < .001), and the basal core promoter (BCP) T1762/A1764 mutation (P < .001). According to the results of multiple logistic-regression analysis, advanced age, male sex, the precore A1896 mutation, the BCP T1762/A1764 mutation, and an HBV load > or = 10(5) copies/mL were independently associated with the development of HCC. Compared with patients with an HBV load < 10(5) copies/mL and the BCP A1762/G1764 wild-type strain, the adjusted OR of developing HCC was > or = 30 in patients with an HBV load > or = 10(5) copies/mL and the BCP T1762/A1764 mutant, irrespective of the presence of the precore A1896 mutation and viral genotype.


CONCLUSIONS
HBV load and the BCP T1762/A1764 mutation are important in hepatocarcinogenesis.
Division of Gastroenterology, Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
Chun-Jen
CJ
Liu
Bing-Fang
BF
Chen
Pei-Jer
PJ
Chen
Ming-Yang
MY
Lai
Wen-Ling
WL
Huang
Jia-Horng
JH
Kao
Ding-Shinn
DS
Chen
D000367:Age Factors; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000821:virology*; D002353:Carrier State / Q000276:immunology / Q000821:virology*; D005260:Female; D005838:Genotype; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000276:immunology / Q000821:virology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000276:immunology / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000821:virology*; D008297:Male; D009154:Mutation; D011401:Promoter Regions, Genetic / Q000235:genetics; D012306:Risk; D019562:Viral Load
D006512:Hepatitis B Core Antigens