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Risk for hepatocellular carcinoma with respect to hepatitis B virus genotypes B/C, specific mutations of enhancer II/core promoter/precore regions and HBV DNA levels
  1. M-F Yuen1,
  2. Y Tanaka2,
  3. N Shinkai2,
  4. R T Poon3,
  5. D Yiu-Kuen But1,
  6. D Y-T Fong4,
  7. J Fung1,
  8. D Ka-Ho Wong1,
  9. J Chi-Hang Yuen1,
  10. M Mizokami2,
  11. C-L Lai1
  1. 1
    Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
  2. 2
    Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  3. 3
    Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong
  4. 4
    Department of Nursing Studies, The University of Hong Kong, Queen Mary Hospital, Hong Kong
  1. Dr M F Yuen, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong; mfyuen{at}hkucc.hku.hk

Abstract

Background/aim: To examine the risks for hepatocellular carcinoma (HCC) with respect to hepatitis B virus (HBV) genotypes, specific viral mutations (MT), serum HBV DNA levels, and cirrhosis.

Methods: HBV genotypes, 1653/1753/core promoter (CP)/precore MT and HBV DNA levels were determined in 248 HBV patients with HCC and 248 HBV controls.

Results: Genotype C, CP-MT, T1653, HBV DNA levels ⩾4 log10 copies/ml and cirrhosis had a higher risk for HCC compared to patients with genotype B (p = 0.001, OR 1.9), CP wild-type (WT) (p<0.001, OR 4.1), C1653 (p = 0.028, OR 2.4), HBV DNA <4 log10 copies/ml (p = 0.003, OR 2.1) and without cirrhosis (p<0.001, OR 4.0) respectively. Multivariate analysis showed that CP-MT, T1653, HBV DNA ⩾4 log10 copies/ml and cirrhosis were independent factors for HCC (all p<0.05). A receiver operating characteristics curve showed no cut-off HBV DNA level associated with minimal chance of HCC. Patients with CP-MT and cirrhosis had a 22.2-fold increased risk of HCC compared to patients with CP-WT and without cirrhosis. Patients with CP-MT and HBV DNA levels ⩾4 log10 copies/ml had a 7.2-fold increased risk of HCC compared to patients with CP-WT and HBV DNA levels <4 log10 copies/ml. Patients with CP-MT and T1653 had a 9.9-fold increased risk of HCC compared to patients with wild-type for both regions.

Conclusions: CP-MT, T1653, HBV DNA levels ⩾4 log10 copies/ml and cirrhosis are independent factors for development of HCC. The risks increased substantially in patients having these factors in combination.

  • HBV genotype
  • core promoter/precore mutations
  • HBV DNA
  • T1653
  • hepatocellular carcinoma

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Footnotes

  • Competing interests: None.

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