Cancer Causes & Control

, Volume 14, Issue 10, pp 995–1000

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


  • Rebecca A. Harris
    • Division of Population ScienceFox Chase Cancer Center
  • Gang Chen
    • Division of Population ScienceFox Chase Cancer Center
  • Wen Yao Lin
    • Haimen City Centers for Disease Control
  • Fu Min Shen
    • Fudan University School of Public Health
  • W. Thomas London
    • Division of Population ScienceFox Chase Cancer Center
    • Division of Population ScienceFox Chase Cancer Center

DOI: 10.1023/

Cite this article as:
Harris, R.A., Chen, G., Lin, W.Y. et al. Cancer Causes Control (2003) 14: 995. doi:10.1023/


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.

Cox proportional hazards regressionHBV DNAhepatitis B virushepatocellular carcinomarisk factorsviral load

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© Kluwer Academic Publishers 2003