Current Hepatitis Reports

, Volume 6, Issue 1, pp 9–16 | Cite as

Serum hepatitis B virus DNA as a predictor of the development of cirrhosis and hepatocellular carcinoma



Chronic hepatitis B frequently progresses to cirrhosis and hepatocellular carcinoma. An elevated serum level of hepatitis B virus DNA is a major risk factor for cirrhosis and hepatocellular carcinoma, and there is a dose-response relationship between the serum hepatitis B virus DNA level and the risk of these complications. To lower the viral load to its lowest level is the method of choice to prevent major liver complications in chronic hepatitis B.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Goldstein ST, Zhou F, Hadler SC, et al.:A mathematical model to estimate global hepatitis B disease burden and vaccination impact.Int J Epidemiol 2005,34:1329–1339.PubMedCrossRefGoogle Scholar
  2. 2.
    Chen CJ, Wang LY, Yu MW:Epidemiology of hepatitis B virus infection in the Asia-Pacific region.J Gastroenterol Hepatol 2000,15(suppl):E3-E6.PubMedCrossRefGoogle Scholar
  3. 3.
    Beasley RP:Hepatitis B virus. The major etiology of hepatocellular carcinoma.Cancer 1988,61:1942–1956.PubMedCrossRefGoogle Scholar
  4. 4.
    Lok AS, McMahon BJ:Chronic hepatitis B.Hepatology 2001,34:1225–1241.PubMedCrossRefGoogle Scholar
  5. 5.
    Perz JF, Armstrong GL, Farrington LA, et al.:The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide.J Hepatol 2006,45:529–538.PubMedCrossRefGoogle Scholar
  6. 6.
    Beasley RP, Trepo C, Stevens CE, Szmuness W:The e antigen and vertical transmission of hepatitis B surface antigen.Am J Epidemiol 1977,105:94–98.PubMedGoogle Scholar
  7. 7.
    McMahon BJ, Alward WL, Hall DB, et al.:Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state.J Infect Dis 1985,151:599–603.PubMedGoogle Scholar
  8. 8.
    Chen DS:From hepatitis to hepatoma: lessons from type B viral hepatitis.Science 1993,262:369–370.PubMedCrossRefGoogle Scholar
  9. 9.
    Chu CM, Liaw YF:Natural history of chronic hepatitis B virus infection: an immunopathological study.J Gastroenterol Hepatol 1997,12:S218-S222.PubMedCrossRefGoogle Scholar
  10. 10.
    Fattovich G, Brollo L, Giustina G, et al.:Natural history and prognostic factors for chronic hepatitis type B.Gut 1991,32:294–298.PubMedCrossRefGoogle Scholar
  11. 11.
    Hsu YS, Chien RN, Yeh CT, et al.:Long-term outcome after spontaneous HBeAg seroconversion in patients with chronic hepatitis B.Hepatology 2002,35:1522–1527.PubMedCrossRefGoogle Scholar
  12. 12.
    Huo T, Wu JC, Hwang SJ, et al.:Factors predictive of liver cirrhosis in patients with chronic hepatitis B: a multivariate analysis in a longitudinal study.Eur J Gastroenterol Hepatol 2000,12:687–693.PubMedCrossRefGoogle Scholar
  13. 13.
    Liaw YF, Tai DI, Chu CM, Chen TJ:The development of cirrhosis in patients with chronic type B hepatitis: a prospective study.Hepatology 1988,8:493–496.PubMedCrossRefGoogle Scholar
  14. 14.
    Lin SM, Sheen IS, Chien RN, et al.:Long-term beneficial effect of interferon therapy in patients with chronic hepatitis B virus infection.Hepatology 1999,29:971–975.PubMedCrossRefGoogle Scholar
  15. 15.
    Yu MW, Hsu FC, Sheen IS, et al.:Prospective study of hepatocellular carcinoma and liver cirrhosis in asymptomatic chronic hepatitis B virus carriers.Am J Epidemiol 1997,145:1039–1047.PubMedGoogle Scholar
  16. 16.
    Fattovich G, Pantalena M, Zagni I, et al.:Effect of hepatitis B and C virus infections on the natural history of compensated cirrhosis: a cohort study of 297 patients.Am J Gastroenterol 2002,97:2886–2895.PubMedCrossRefGoogle Scholar
  17. 17.
    de Jongh FE, Janssen HL, de Man RA, et al.:Survival and prognostic indicators in hepatitis B surface antigen-positive cirrhosis of the liver.Gastroenterology 1992,103:1630–1635.PubMedGoogle Scholar
  18. 18.
    Chen CJ, Yu MW, Liaw YF:Epidemiological characteristics and risk factors of hepatocellular carcinoma.J Gastroenterol Hepatol 1997,12:S294-S308.PubMedCrossRefGoogle Scholar
  19. 19.
    Beasley RP:Hepatitis B virus as the etiological agent in hepatocellular carcinoma: epidemiological consideration.Hepatology 1982,2:21–26.Google Scholar
  20. 20.
    Chen CJ, Yang HI, Su J, et al.:Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level.JAMA 2006,295:65–73.PubMedCrossRefGoogle Scholar
  21. 21.
    Iloeje UH, Yang HI, Su J, et al.:Predicting cirrhosis risk based on the level of circulating hepatitis B viral load.Gastroenterology 2006,130:678–686.PubMedCrossRefGoogle Scholar
  22. 22.
    Yu MW, Yeh SH, Chen PJ, et al.:Hepatitis B virus genotype and DNA level and hepatocellular carcinoma: a prospective study in men.J Natl Cancer Inst 2005,97:265–272.PubMedCrossRefGoogle Scholar
  23. 23.
    You SL, Yang HI, Chen CJ:Seropositivity of hepatitis B e antigen and hepatocellular carcinoma.Ann Med 2004,36:215–224.PubMedCrossRefGoogle Scholar
  24. 24.
    Niederau C, Heintges T, Lange S, et al.:Long-term follow-up of HBeAg-positive patients treated with interferon alfa for chronic hepatitis B.N Engl J Med 1996,334:1422–1427.PubMedCrossRefGoogle Scholar
  25. 25.
    Fattovich G, Giustina G, Schalm SW, et al.:Occurrence of hepatocellular carcinoma and decompensation in western European patients with cirrhosis type B. The EUROHEP Study Group on Hepatitis B Virus and Cirrhosis.Hepatology 1995,21:77–82.PubMedGoogle Scholar
  26. 26.
    McMahon BJ, Holck P, Bulkow L, Snowball M:Serologic and clinical outcomes of 1536 Alaska Natives chronically infected with hepatitis B virus.Ann Intern Med 2001,135:759–768.PubMedGoogle Scholar
  27. 27.
    Yang HI, Lu SN, Liaw YF, et al.:Hepatitis B e antigen and the risk of hepatocellular carcinoma.N Engl J Med 2002,347:168–174.PubMedCrossRefGoogle Scholar
  28. 28.
    Chen CJ, Yang HI, You SL:Hepatitis B e antigen and the risk of hepatocellular carcinoma [author reply].N Engl J Med 2002,347:1722.CrossRefGoogle Scholar
  29. 29.
    Yuan HJ, Yuen MF, Ka-Ho Wong D, et al.:The relationship between HBV-DNA levels and cirrhosis-related complications in Chinese with chronic hepatitis B.J Viral Hepat 2005,12:373–379.PubMedCrossRefGoogle Scholar
  30. 30.
    Chen G, Lin W, Shen F, et al.:Past HBV viral load as predictor of mortality and morbidity from HCC and chronic liver disease in a prospective study.Am J Gastroenterol 2006,101:1797–1803.PubMedCrossRefGoogle Scholar
  31. 31.
    Ikeda K, Arase Y, Kobayashi M, et al.:Consistently low hepatitis B virus DNA saves patients from hepatocellular carcinogenesis in HBV-related cirrhosis. A nested case-control study using 96 untreated patients.Intervirology 2003,46:96–104.PubMedCrossRefGoogle Scholar
  32. 32.
    Tang B, Kruger WD, Chen G, et al.:Hepatitis B viremia is associated with increased risk of hepatocellular carcinoma in chronic carriers.J Med Virol 2004,72:35–40.PubMedCrossRefGoogle Scholar
  33. 33.
    Liu CJ, Chen BF, Chen PJ, et al.:Role of hepatitis B viral load and basal core promoter mutation in hepatocellular carcinoma in hepatitis B carriers.J Infect Dis 2006,193:1258–1265.PubMedCrossRefGoogle Scholar
  34. 34.
    Ohata K, Hamasaki K, Toriyama K, et al.:High viral load is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis B virus infection.J Gastroenterol Hepatol 2004,19:670–675.PubMedCrossRefGoogle Scholar
  35. 35.
    Mahmood S, Niiyama G, Kamei A, et al.:Influence of viral load and genotype in the progression of hepatitis B-associated liver cirrhosis to hepatocellular carcinoma.Liver Int 2005,25:220–225.PubMedCrossRefGoogle Scholar
  36. 36.
    Ikeda K, Arase Y, Kobayashi M, et al.:Hepatitis B virus-related hepatocellular carcinogenesis and its prevention.Intervirology 2005,48:29–38.PubMedCrossRefGoogle Scholar
  37. 37.
    Chien YC, Jan CF, Kuo HS, Chen CJ:Nationwide hepatitis B vaccination program in Taiwan: effectiveness in the 20 years after it was launched.Epidemiol Rev 2006,28:126–135.PubMedCrossRefGoogle Scholar
  38. 38.
    Centers for Disease Control and Prevention (CDC):Global progress towards universal childhood hepatitis B vaccination.MMWR 2003,52:868–870.Google Scholar
  39. 39.
    Merican I, Guan R, Amarapuka D, et al.:Chronic hepatitis B virus infection in Asian countries.J Gastroenterol Hepatol 2000,15:1356–1361.PubMedCrossRefGoogle Scholar
  40. 40.
    Da Silva LC, Madruga CL, Carrilho FJ, et al.:Spontaneous hepatitis B surface antigen clearance in a long-term follow-up study of patients with chronic type B hepatitis. Lack of correlation with hepatitis C and D virus superinfection.J Gastroenterol 1996,31:696–701.PubMedCrossRefGoogle Scholar
  41. 41.
    Liaw YF, Sheen IS, Chen TJ, et al.:Incidence, determinants and significance of delayed clearance of serum HBsAg in chronic hepatitis B virus infection: a prospective study.Hepatology 1991,13:627–631.PubMedCrossRefGoogle Scholar
  42. 42.
    Sampliner RE, Hamilton FA, Iseri OA, et al.:The liver histology and frequency of clearance of the hepatitis B surface antigen (HBsAg) in chronic carriers.Am J Med Sci 1979,277:17–22.PubMedCrossRefGoogle Scholar
  43. 43.
    Wu TT, Hsu HC, Chen DS, et al.:Clearance of hepatitis B surface antigen (HBsAg) after surgical resection of hepatocellular carcinoma.J Hepatol 1987,4:45–51.PubMedCrossRefGoogle Scholar
  44. 44.
    de Franchis R, Hadengue A, Lau G, et al.:EASL International Consensus Conference on Hepatitis B. 13–14 September, 2002 Geneva, Switzerland. Consensus statement (long version).J Hepatol 2003,39(suppl 1):S3-S25.PubMedGoogle Scholar
  45. 45.
    Liaw YF, Leung N, Guan R, et al.:Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2005 update.Liver Int 2005,25:472–489.PubMedCrossRefGoogle Scholar
  46. 46.
    Lok AS, McMahon BJ:Chronic hepatitis B: update of recommendations.Hepatology 2004,39:857–861.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  • Chien-Jen Chen
    • 1
  • Uchenna H. Iloeje
    • 1
  • Hwai-I Yang
    • 1
  1. 1.Genomics Research CenterAcademia SinicaNankang, TaipeiTaiwan

Personalised recommendations