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 9.8) 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). 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 21.3 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 mutation
- hepatocellular carcinoma
- precore mutation