title: Impact of serial hepatitis B virus DNA on hepatocellular carcinoma development in patients with liver cirrhosis.
abstract: OBJECTIVE
  We investigated the pattern of serial HBV DNA levels in known cirrhosis patients and its impact on the development of hepatocellular carcinoma (HCC).
  
  
  METHODS
  We analyzed a retrospective case/control study based on 352 HCC patients associated with HBV between 2005 and 2007. Prior to HCC development, 49 cirrhosis patients were tested for HBV DNA levels more than once a year (median 4 times) during the follow-up period. Ninety-eight consecutive cirrhosis patients without HCC, matched for age, sex and HBe Ag status were included as controls. Eighty-three patients in both groups had undergone antiviral therapy.
  
  
  RESULTS
  In cirrhosis, the most common HBV DNA pattern was fluctuating (33.3%), followed by persistently high (> or =10(4) copies/ml, 23.8%). Compared to a persistently low pattern (<10(4) copies/ml), the relative risks of HCC in patients with persistently high and fluctuating patterns were 2.650 and 1.475. At multivariate analysis, a persistently high pattern was an independent risk factor for HCC (hazard ratio 3.135). Patients with sustained HBV DNA suppression during antiviral therapy were less likely to develop HCC than those with viral breakthrough/nonresponse.
  
  
  CONCLUSIONS
  This study showed that persistent suppression of HBV DNA is also important to prevent the development of HCC in known cirrhosis patients.
authors: Department of Internal Medicine, College of Medicine, WHO Collaborating Center on Viral Hepatitis, The Catholic University of Korea, Seoul, Korea.
authors: Jung Hyun
authors: JH
authors: Kwon
authors: Jong Young
authors: JY
authors: Choi
authors: Jeong Won
authors: JW
authors: Jang
authors: Si Hyun
authors: SH
authors: Bae
authors: Seung Kew
authors: SK
authors: Yoon
authors: Jin Mo
authors: JM
authors: Yang
authors: Nam Ik
authors: NI
authors: Han
authors: Chang Don
authors: CD
authors: Lee
authors: Young Seok
authors: YS
authors: Lee
authors: Kyu Won
authors: KW
authors: Chung
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D016022:Case-Control Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral