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Spontaneous clearance of high-titer serum HBV DNA and risk of hepatocellular carcinoma in a Chinese population

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Abstract

Chronic hepatitis B virus (HBV) carriers with high-titer viremia (>105 virions/ml) are at increased risk for hepatocellular carcinoma (HCC). The aim of this study was to determine the relationship between clearance of high-titer viremia and subsequent risk of HCC. The study population was a prospective cohort of 114 adults from Haimen City, China, all HBV DNA(+) at study entry and followed for 797.8 person-years in total. During follow-up, 54 (47.4%) subjects spontaneously cleared high-titer viremia at least once. Of these, 27 were considered to have undergone stable seroconversion, 16 were considered unstable (12 reversions to HBV DNA positivity and 4 multiple clearances), and 11 did not have sufficient follow-up to determine stability. Of the 114 persons, 26 (22.8%) died during follow-up, 21 (18.4%) from HCC. Using Cox proportional hazards models, the RR of HCC death associated with seroconversion was 2.8 (95% CI = 1.1–7.4), controlling for age, sex, family HCC history, history of acute hepatitis, alcohol use and cigarette smoking. In conclusion, fluctuations of high-titer viremia may indicate increased hepatocellular damage and at least short-term increases in HCC risk. Long-term longitudinal studies are needed to clarify this relationship and its potential usefulness as a prognostic marker in chronic HBV infection.

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References

  1. IARC (1994) Monographs on the Evaluation of Carcinogenic Risk to Humans. IARC Monographs 59: 45-221.

    Google Scholar 

  2. Hsu Y-S,Chien R-N,Yeh C-T, et al. (2002) Long-term outcome after spontaneous HBeAg seroconversion in patients with chronic hepatitis B. Hepatology 35: 1522-1527.

    Google Scholar 

  3. McMahon BJ,Holck P,Bulkow L,Snowball M (2001) Serologic and clinical outcomes of 1536 Alaska natives chronically infected with hepatitis B virus. Ann Intern Med 135: 759-768.

    Google Scholar 

  4. Yang H-I,Lu S-N,Liaw Y-F, et al. (2002) Hepatitis B e antigen and the risk of hepatocellular carcinoma. N Engl J Med 347: 168-174.

    Google Scholar 

  5. Evans AA,Chen G,Ross EA,Shen FM,Lin WY,London WT (2002) Eight year follow-up of the 90,000 person Haimen City Cohort: I. Hepatocellular carcinoma mortality, risk factors, and gender differences. Cancer Epidemiol Biomarkers Prev 11: 369-376.

    Google Scholar 

  6. Lok ASF,McMahon BJ (2001) Chronic hepatitis B. Hepatology 34: 1225-1241.

    Google Scholar 

  7. Nowak MA,Bonhoeffer S,Hill AM,Boehme R,Thomas HC,McDade H (1996) Viral dynamics in hepatitis B virus infection. Proc Natl Acad Sci USA 93: 4398-4402.

    Google Scholar 

  8. Seeger C,Mason WS (2000) Hepatitis B virus biology. Microbiol Mol Biol Rev 64: 51-68.

    Google Scholar 

  9. Berman JJ (1988) Cell proliferation and the aetiology of hepatocellular carcinoma. J Hepatol 7: 305-309.

    Google Scholar 

  10. Balsara BR,Pei J,De Rienzo A, et al. (2001) Human hepatocellular carcinoma is characterized by a highly consistent pattern of genomic imbalances, including frequent loss of 16q23.1-24.1. Genes Chromosomes Cancer 30: 245-253.

    Google Scholar 

  11. Levy L,Renard CA,Wei Y,Buendia MA (2002) Genetic alterations and oncogenic pathways in hepatocellular carcinoma. Ann NY Acad Sci 963: 21-36.

    Google Scholar 

  12. Thorgeirsson SS,Grisham JW (2002) Molecular pathogenesis of human hepatocellular carcinoma. Nat Genet 31: 339-346.

    Google Scholar 

  13. Comanor L,Minor J,Conjeevaram HS, et al. (2000) Statistical models for predicting response to interferon-a and spontaneous seroconversion in children with chronic hepatitis B. J Viral Hepatitis 7: 144-152.

    Google Scholar 

  14. Tsiang M,Rooney JF,Toole JJ,Gibbs CS (1999) Biphasic clearance kinetics of hepatitis B virus from patients during adefovir dipivoxil therapy. Hepatology 29: 1863-1869.

    Google Scholar 

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Correspondence to Alison A. Evans.

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Harris, R.A., Chen, G., Lin, W.Y. et al. Spontaneous clearance of high-titer serum HBV DNA and risk of hepatocellular carcinoma in a Chinese population. Cancer Causes Control 14, 995–1000 (2003). https://doi.org/10.1023/B:CACO.0000007984.79987.ec

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  • DOI: https://doi.org/10.1023/B:CACO.0000007984.79987.ec

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