Cancer Causes & Control

, Volume 14, Issue 10, pp 995–1000 | Cite as

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

  • Rebecca A. Harris
  • Gang Chen
  • Wen Yao Lin
  • Fu Min Shen
  • W. Thomas London
  • Alison A. Evans


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 regression HBV DNA hepatitis B virus hepatocellular carcinoma risk factors viral load 


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Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Rebecca A. Harris
    • 1
  • Gang Chen
    • 1
  • Wen Yao Lin
    • 2
  • Fu Min Shen
    • 3
  • W. Thomas London
    • 1
  • Alison A. Evans
    • 4
  1. 1.Division of Population ScienceFox Chase Cancer CenterPhiladelphiaUSA
  2. 2.Haimen City Centers for Disease ControlHaimen CityPR China
  3. 3.Fudan University School of Public HealthShanghaiPR China
  4. 4.Division of Population ScienceFox Chase Cancer CenterPhiladelphiaUSA

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