Impact of serial hepatitis B virus DNA on hepatocellular carcinoma development in patients with liver cirrhosis.
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.
Kwon
Jung Hyun
JH
Department of Internal Medicine, College of Medicine, WHO Collaborating Center on Viral Hepatitis, The Catholic University of Korea, Seoul, Korea.
Choi
Jong Young
JY
Jang
Jeong Won
JW
Bae
Si Hyun
SH
Yoon
Seung Kew
SK
Yang
Jin Mo
JM
Han
Nam Ik
NI
Lee
Chang Don
CD
Lee
Young Seok
YS
Chung
Kyu Won
KW
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
D000998:Antiviral Agents; D004279:DNA, Viral