title: Effect of functional nuclear factor-kappaB genetic polymorphisms on hepatitis B virus persistence and their interactions with viral mutations on the risk of hepatocellular carcinoma.
abstract: BACKGROUND
  Nonresolving inflammation and viral mutations are important in hepatitis B virus (HBV)-induced hepatocarcinogenesis. However, the effects of genetic polymorphisms affecting nuclear factor-kappaB (NF-κB) on HBV persistence and generation of hepatocellular carcinoma (HCC)-related HBV mutations remain unknown.
  
  
  METHODS
  rs28362491 (NFKB1 -94Ins > Del), rs2233406 (NFKBIA -826C > T), rs3138053 (NFKBIA -881A > G), and rs696 (NFKBIA +2758G > A) were genotyped in 1342 healthy controls, 327 HBV-clearance subjects, and 3976 HBV-positive subjects including 1495 HCC patients, using quantitative PCR. HBV mutations were determined by sequencing. The NFKBIA promoter activity was assessed by transient transfection. Multiplicative interactions of the polymorphisms and viral mutations were assessed by multivariate logistic regression.
  
  
  RESULTS
  Compared with HBV-clearance subjects, rs2233406 (CT versus CC) and rs3138053 (AG or AG + GG versus AA) significantly decreased HBV persistence, especially in the genotype B HBV-infected subjects. In the genotype C HBV-infected subjects, rs2233406 variant genotypes were significantly associated with an increased risk of HCC [CT versus CC: age-, gender-adjusted odds ratio (AOR), 1.33; 95% confidence interval (CI) 1.01-1.75 in training set and AOR, 1.59; 95% CI 1.01-2.52 in validation set] compared with HCC-free HBV-infected subjects and significantly increased the frequencies of HCC-related HBV mutations (A1762T/G1764A, T1753V, preS1 start codon mutation, and preS deletion); rs28362491 (Del/Del or Ins/Del + Del/Del versus Ins/Ins) significantly increased the frequency of A1762T/G1764A and reduced the frequency of preS2 start codon mutation. The variant genotypes impaired NFKBIA promoter activity in hepatic cells. The interaction of rs2233406 variant genotypes (CT + TT versus CC) with A1762T/G1764A significantly increased HCC risk in genotype C HBV-infected subjects, with AOR of 2.61 (95% CI 1.09-6.26).
  
  
  CONCLUSIONS
  Genetic polymorphisms improving NF-κB activity contribute to genotype B HBV clearance. The rs2233406 variant genotypes significantly increase HCC risk, possibly via facilitating immune selection of the HBV mutations. The host-virus interactions are important in identifying HBV-infected subjects who are more likely to develop HCC.
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: X W
authors.initials: XW
authors.lastname: Ji
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: X M
authors.initials: XM
authors.lastname: Hou
authors.affiliation: Department of Microbiology, School of Basic Medical Science, Peking University Health Science Center, Beijing.
authors.forename: F M
authors.initials: FM
authors.lastname: Lu
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: Y
authors.initials: Y
authors.lastname: Du
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: J H
authors.initials: JH
authors.lastname: Yin
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: X Y
authors.initials: XY
authors.lastname: Sun
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: Y
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Institute/Hospital, Second Military Medical University, Shanghai.
authors.forename: J
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Division of Chronic Diseases, Center for Disease Control and Prevention of Yangpu District, Shanghai.
authors.forename: X
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Institute/Hospital, Second Military Medical University, Shanghai.
authors.forename: G S
authors.initials: GS
authors.lastname: Yang
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai.
authors.forename: H W
authors.initials: HW
authors.lastname: Zhang
authors.affiliation: Department of Microbiology, School of Basic Medical Science, Peking University Health Science Center, Beijing.
authors.forename: X M
authors.initials: XM
authors.lastname: Chen
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing.
authors.forename: H B
authors.initials: HB
authors.lastname: Shen
authors.affiliation: International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute/Hospital, Second Military Medical University, Shanghai, China.
authors.forename: H Y
authors.initials: HY
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, Second Military Medical University, Shanghai. Electronic address: gcao@smmu.edu.cn.
authors.forename: G W
authors.initials: GW
authors.lastname: Cao
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000235:genetics / Q000821:virology*; D020022:Genetic Predisposition to Disease; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics / Q000821:virology*; D009154:Mutation; D016328:NF-kappa B / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D011401:Promoter Regions, Genetic
chemical_list: D016328:NF-kappa B
keywords: NF-κB; hepatitis B virus; hepatocellular carcinoma; interaction; polymorphism; viral mutation