title: Association of hepatitis B virus pre-S deletions with the development of hepatocellular carcinoma in chronic hepatitis B.
abstract: BACKGROUND
  We aimed to determine whether hepatitis B virus (HBV) pre-S deletion was an independent factor for the development of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Pre-S deletions were determined in HBV isolates from 115 chronic hepatitis B (CHB) patients with HCC. Sixty-nine patients were further matched with 69 CHB patients without HCC for age, sex, hepatitis B e antigen (HBeAg) status, and HBV genotype.
  
  
  RESULTS
  HBV pre-S deletions were clustered mainly in the 3' end of pre-S1 and 5' end of pre-S2 regions. Adjusted for confounding risk factors, patients with HCC had a higher prevalence of HBV with pre-S deletions than did patients without HCC (23 [33.3%] of 69 vs 11 [15.9%] of 69; P = .018; odds ratio [OR], 2.64). In particular, only pre-S2 deletions but not pre-S1 deletions were significantly associated with the development of HCC (P = .020). A higher prevalence of pre-S deletions was observed in HBV isolates from HCC patients under the age of 50 years than from those older than 50 years (10 [62.5%] of 16 vs 13 [24.5%] of 53; P = .012; OR, 5.13). Emergence of de novo pre-S deletions was documented before the development of HCC.
  
  
  CONCLUSIONS
  HBV pre-S2 deletions were an independent factor associated with the development of HCC. Its oncogenic role may be more important in young patients with HCC.
authors.affiliation: Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Taiwan.
authors.forename: Pok
authors.initials: P
authors.lastname: Yeung
authors.forename: Danny Ka-Ho
authors.initials: DK
authors.lastname: Wong
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
authors.forename: James
authors.initials: J
authors.lastname: Fung
authors.forename: Wai-Kay
authors.initials: WK
authors.lastname: Seto
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen
mesh_terms: D000328:Adult; D000368:Aged; D000595:Amino Acid Sequence; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000235:genetics / Q000821:virology*; D016022:Case-Control Studies; D017931:DNA Primers; D030561:Databases, Nucleic Acid; D005260:Female; D017353:Gene Deletion; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000737:chemistry / Q000235:genetics; D006515:Hepatitis B virus / Q000737:chemistry / Q000145:classification / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000235:genetics / Q000821:virology*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D011498:Protein Precursors / Q000737:chemistry / Q000235:genetics; D012307:Risk Factors; D016415:Sequence Alignment
chemical_list: D017931:DNA Primers; D006514:Hepatitis B Surface Antigens; D011498:Protein Precursors