A weak association between occult HBV infection and non-B non-C hepatocellular carcinoma in Japan.
BACKGROUND
In Japan, approximately 10% of hepatocellular carcinoma (HCC) patients are negative for both hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C virus (anti-HCV), i.e., they constitute the so-called category of non-B non-C (NBNC) HCC. Little is known about the characteristics of NBNC-HCC.


METHODS
Potential risk factors for carcinogenesis (including occult HBV infection [HBsAg is negative but HBV DNA is positive by polymerase chain reaction (PCR)], obesity, and diabetes) were assessed in 233 HCC patients grouped according to hepatitis virus serological status (152 with HCV-HCC, 36 with HBV-HCC, and 45 with NBNC-HCC).


RESULTS
The prevalence of patients with obesity or diabetes was significantly higher in the NBNC-HCC group than in the HBV-HCC group. The same trend was observed even when patients with massive alcohol intake were excluded from the analysis. Only 8 patients (18%) in the NBNC-HCC group had detectable serum HBV DNA, and this was at very low levels (HBV/Ce/C2 and HBV/D were determined in 7 and 1 patients, respectively). In the NBNC-HCC group, the determined nucleotide sequences of the enhancer II/core promoter/precore/core region did not contain any HCC-associated mutations, whereas 25 of 30 patients in the HBV-HCC group carried strains with C1653T, T1753V, and/or A1762T/G1764A mutations.


CONCLUSIONS
A weak association between occult HBV infection and HCC development was observed in the NBNC patients. This study indicates that nonalcoholic steato-hepatitis should be further investigated to assess its contribution to HCC development in this category of patients.
Kusakabe
Atsunori
A
Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan.
Tanaka
Yasuhito
Y
Orito
Etsuro
E
Sugauchi
Fuminaka
F
Kurbanov
Fuat
F
Sakamoto
Tomoyuki
T
Shinkai
Noboru
N
Hirashima
Noboru
N
Hasegawa
Izumi
I
Ohno
Tomoyoshi
T
Ueda
Ryuzo
R
Mizokami
Masashi
M
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012307:Risk Factors
D004279:DNA, Viral