title: Association of concurrent hepatitis B surface antigen and antibody to hepatitis B surface antigen with hepatocellular carcinoma in chronic hepatitis B virus infection.
abstract: Antibody to hepatitis B surface antigen (HBsAg) (anti-HBs) can exist in patients with chronic hepatitis B virus (HBV) infection. To date, little is known about the association of concurrent HBsAg and anti-HBs (concurrent HBsAg/ anti-HBs) with hepatocellular carcinoma (HCC). The aim of this study was to investigate the clinical relevance of concurrent HBsAg/anti-HBs with preS deletion mutations and HCC in chronic HBV infection. A total of 755 patients with chronic HBV infection were included consecutively at a tertiary center. Logistic regression analysis was used to identify risk factors for HCC, and serum HBV DNA was amplified, followed by direct sequencing to detect preS deletions. The prevalence of concurrent HBsAg/anti-HBs was 6.4% (48/755) and all HBVs tested were genotype C. HCC occurred more frequently in the concurrent HBsAg/anti-HBs group than in the HBsAg only group [22.9% (11/48) vs. 7.9% (56/707), P = 0.002]. In multivariate analyses, age >40 years [odds ratio (OR), 14.712; 95% confidence interval (CI), 4.365-49.579; P < 0.001], male gender (OR 2.431; 95% CI, 1.226-4.820; P = 0.011), decompensated cirrhosis (OR, 3.642; 95% CI, 1.788-7.421; P < 0.001) and concurrent HBsAg/anti-HBs (OR, 4.336; 95% CI, 1.956-9.613; P < 0.001) were associated independently with HCC. In molecular analysis, preS deletion mutations were more frequent in the concurrent HBsAg/anti-HBs and HCC groups than in the HBsAg without HCC group (42.3% and 32.5% vs. 11.3%; P = 0.002 and 0.012, respectively). In conclusion, concurrent HBsAg/anti-HBs is associated with preS deletion mutations and may be one of the risk factors for HCC in chronic HBV infection with genotype C.
authors.affiliation: Department of Internal Medicine, Hallym University Medical Center, Kangdong-Gu, Seoul, South Korea.
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Jang
authors.forename: Hyoung Su
authors.initials: HS
authors.lastname: Kim
authors.forename: Ha Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Woon Geon
authors.initials: WG
authors.lastname: Shin
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Kim
authors.forename: Jin Heon
authors.initials: JH
authors.lastname: Lee
authors.forename: Hak Yang
authors.initials: HY
authors.lastname: Kim
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Myung Seok
authors.initials: MS
authors.lastname: Lee
authors.forename: Choong Kee
authors.initials: CK
authors.lastname: Park
authors.forename: Byung-Hoon
authors.initials: BH
authors.lastname: Jeong
authors.forename: Yong-Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Myoung Kuk
authors.initials: MK
authors.lastname: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood / Q000737:chemistry / Q000235:genetics; D005260:Female; D005838:Genotype; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000235:genetics; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000276:immunology* / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D017422:Sequence Analysis, DNA / Q000379:methods; D017384:Sequence Deletion; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens