Basal core promoter mutation is associated with progression to cirrhosis rather than hepatocellular carcinoma in chronic hepatitis B virus infection.
BACKGROUND
As most cases of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) have concurrent cirrhosis, viral factors identified to be associated with HCC might be related to cirrhosis rather than HCC.


METHODS
Hepatitis B virus DNA levels, genotypes and precore/basal core promoter (BCP) mutants were compared between cirrhotic HCC and non-cirrhotic HCC patients. Age- and sex-matched case-control studies were performed to identify the risk factors.


RESULTS
Hepatitis B virus DNA levels showed no significant difference between non-cirrhotic HCC patients (n=20) and cirrhotic HCC patients (n=140) or 1 : 3 age- and sex-matched cirrhotic HCC patients (n=60), but genotype C and BCP mutant were significantly more prevalent in the latter than in the former. In multiple logistic regression, BCP mutant but not genotype C correlated significantly with the presence of cirrhosis in HCC patients. Compared with inactive carriers (n=60), non-cirrhotic HCC patients (n=20) had significantly higher HBV DNA levels but no difference in HBV genotypes and precore/BCP mutants. Furthermore, HBV DNA levels, the distribution of HBV genotypes and the prevalence of precore/BCP mutants all failed to show any significant difference between cirrhotic HCC patients (n=60) and cirrhotic patients without HCC (n=60).


CONCLUSIONS
Basal core promoter mutant is associated with progression to cirrhosis rather than HCC in chronic HBV infection.
Liver Research Unit, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 199, Tung Hwa North Road, Taipei 10591, Taiwan. chiamingchu@yahoo.com.tw
C-M
CM
Chu
C-C
CC
Lin
Y-C
YC
Chen
W-J
WJ
Jeng
S-M
SM
Lin
Y-F
YF
Liaw
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000821:virology; D016022:Case-Control Studies; D004279:DNA, Viral / Q000235:genetics; D018450:Disease Progression; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000235:genetics* / Q000821:virology*; D008113:Liver Neoplasms / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011401:Promoter Regions, Genetic / Q000235:genetics
D004279:DNA, Viral