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Hepatitis B viremia is associated with increased risk of hepatocellular carcinoma in chronic carriers
Journal article   Peer reviewed

Hepatitis B viremia is associated with increased risk of hepatocellular carcinoma in chronic carriers

Baiqing Tang, Warren D Kruger, Gang Chen, Fumin Shen, Wen Yao Lin, Souleymane Mboup, W Thomas London and Alison A Evans
Journal of medical virology, v 72(1)
Jan 2004
PMID: 14635008

Abstract

Taq Polymerase Carcinoma, Hepatocellular - epidemiology Prospective Studies Humans Middle Aged DNA, Viral - analysis Male Case-Control Studies Viral Load Liver Neoplasms - epidemiology China Polymerase Chain Reaction Adult Female Hepatitis B virus Liver Neoplasms - virology Military Personnel Carcinoma, Hepatocellular - virology Hepatitis B, Chronic - virology Viremia - complications Carrier State - virology Hepatitis B, Chronic - complications Viremia - virology Senegal Aged Cohort Studies
The role of quantitative viral load in development of hepatocellular carcinoma (HCC) among chronic hepatitis B virus (HBV) carriers was evaluated using real-time PCR (TaqMan PCR), a highly sensitive method for quantitative detection of HBV DNA. Serum samples collected at study entry from HCC cases and matched controls were chosen separately from ongoing prospective cohort studies in Senegal, West Africa, and Haimen City, China. For 14 HCC cases and 28 controls from Senegal, the relative risk (RR, 95% CI) of HCC was 15.6 (2.0-124.3) for those positive by the TaqMan PCR assay. Average length of follow-up (study entry to death from HCC) among cases was 2.8 (+/-1.6) years. The paired median difference between cases and controls was 3.8 x 10(4) virions/ml, with cases higher (P = 0.09). In order to clarify the relationship with lower-titer viremia, we selected 55 cases and 55 matched controls from the Chinese cohort all negative for serum HBV DNA by conventional dot blot hybridization. In this group, the RR associated with HBV DNA positivity by TaqMan PCR was 3.1 (1.1-9.2), with an average duration of follow-up of 3.3 (+/-2.1) years. The median difference in quantitative viremia between cases and controls was 6.0 x 10(4) virions/ml, with cases higher (P < 0.0001). Increased risk appeared to be confined to subjects with viral loads >2.3 x 10(4) virions/ml. In conclusion, HBV viremia, except perhaps at extremely low levels, is associated with increased risk for HCC in prospective studies of chronic carriers in two disparate populations.

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Virology
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