title: A weak association between occult HBV infection and non-B non-C hepatocellular carcinoma in Japan.
abstract: 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.
authors.affiliation: Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kusakabe
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Etsuro
authors.initials: E
authors.lastname: Orito
authors.forename: Fuminaka
authors.initials: F
authors.lastname: Sugauchi
authors.forename: Fuat
authors.initials: F
authors.lastname: Kurbanov
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Noboru
authors.initials: N
authors.lastname: Shinkai
authors.forename: Noboru
authors.initials: N
authors.lastname: Hirashima
authors.forename: Izumi
authors.initials: I
authors.lastname: Hasegawa
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Ohno
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ueda
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
mesh_terms: 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
chemical_list: D004279:DNA, Viral