Hepatitis B DNA Level a Strong Predictor of Liver Cancer

Predictor is independent of hepatitis B e antigen seropositivity, serum ALT and liver cirrhosis

WEDNESDAY, Jan. 4 (HealthDay News) -- Risk of hepatocellular carcinoma is strongly associated with serum hepatitis B virus DNA levels of 10,000 copies/mL or greater, Taiwanese researchers report in the Jan. 4 issue of the Journal of the American Medical Association.

Chien-Jen Chen, Sc.D., and colleagues at National Taiwan University in Taipei, conducted a prospective study of 3,653 subjects seropositive for hepatitis B surface antigen and seronegative for hepatitis C antibodies. Patients were participants in a community-based cancer screening program.

There were 164 cases of hepatocellular cancer and 346 deaths during 11.4 years of follow-up. The incidence of liver cancer rose in a dose-response fashion to rising serum HBV DNA levels. There were 108 cases of liver cancer per 100,000 person-years with HBV DNA levels below 300 copies/mL. There were 1,152 cases per 100,000 person-years with HBV DNA levels of 1 million copies/mL or greater.

The cumulative incidence of liver cancer was 1.3% with HBV DNA levels below 300 copies/mL. For HBV DNA copies of 1 million/mL or greater, the cumulative incidence was 14.9%. Risk with elevated HBV DNA was independent of hepatitis B e antigen (HBeAg) serostatus, serum alanine aminotransferase (ALT) and the presence of liver cirrhosis.

"These patients, especially those seronegative for HBeAg, account for an increasing majority of chronically infected individuals and are at increased risk of future hepatocellular carcinoma," the authors write.

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