Pre-S2 deletions of hepatitis B virus and hepatocellular carcinoma in children.
The cause of early oncogenesis in hepatitis B virus (HBV)-related childhood hepatocellular carcinoma (HCC) remains unclear. This study investigated whether pre-S deletion of HBV is related to childhood HCC. By using nested polymerase chain reaction, we compared the pre-S sequence of HBV from sera of children with HCC against control children with similar chronic HBV infection. The HBV in sera of children with HCC had a significantly higher rate of pre-S deletion than that of children with chronic HBV infection (p = 0.008). All except one of the pre-S deletions from the HCC group involved the pre-S2 region, whereas no pre-S2 deletion was found in the chronic HBV group (p = 0.003). There was a trend whereby genotype-C sera had a higher rate of pre-S2 deletion than genotype-B sera (p = 0.11). A multivariate logistic regression model revealed that pre-S deletion was an independent risk factor for HCC in children (odds ratio: 36.69, p = 0.015). In conclusion, pre-S2 deletion does not need to take decades to occur; its presence in nearly half of children with HCC, in contrast to its absence in children with chronic HBV infection, suggests a link between pre-S2 deletion and HCC development in children.


BACKGROUND
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Huang
Hsiang-Po
HP
Department of Medical Research, National Taiwan University Hospital, Taipei 100, Taiwan.
Hsu
Hong-Yuan
HY
Chen
Chi-Ling
CL
Ni
Yen-Hsuan
YH
Wang
Hurng-Yi
HY
Tsuei
Daw-Jen
DJ
Chiang
Cheng-Lun
CL
Tsai
Yi-Chen
YC
Chen
Huey-Ling
HL
Chang
Mei-Hwei
MH
D000293:Adolescent; D001483:Base Sequence; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D002648:Child; D017931:DNA Primers; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008113:Liver Neoplasms / Q000821:virology*; D008297:Male; D016133:Polymerase Chain Reaction; D011498:Protein Precursors / Q000235:genetics*; D012307:Risk Factors
D017931:DNA Primers; D006514:Hepatitis B Surface Antigens; D011498:Protein Precursors; C050807:presurface protein 2, hepatitis B surface antigen