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High HBV Viral Load Linked to Greater Risk of Liver Cancer

Having a high blood level of hepatitis B virus (HBV) DNA increases the likelihood of developing hepatocellular carcinoma (HCC), a form of primary liver cancer, according to a study described in the January 13, 2012, Journal of Virology.

Over years or decades chronic hepatitis B or C can lead to advanced liver disease, including cirrhosis and HCC. But the relationship between HBV viral load and risk of disease progression is not fully understood, and prior studies have yielded conflicting results.

Jin-Yong Zhou from Nanjing University Medical School in China and colleaguesdesigned a study to clarify whether high HBV DNA is associated with HCC development, by comparing viral load levels in hepatitis B patients with and without liver cancer.

The analysis included 78 men and 12 women with HCC and an equal number of participants without liver cancer. Average age was similar across groups (52 years); 38 of the patients with HCC and 12 of those without HCC were hepatitis B "e" antigen (HBeAg) positive. Most Chinese hepatitis B patients are assumed to have been infected at birth.

Results

• The mean HBV DNA level for participants with HCC was 4.73 log₁₀ IU/mL, compared with 3.90 log₁₀ IU/mL for those without HCC, a significant difference (P < 0.01).
• Patients with HCC were significantly more likely than those without liver cancer to be HBeAg positive (42.2% vs 13.3%, respectively; P < 0.001).
• Compared to people with HBV DNA less than 3 log₁₀ IU/mL, odds ratios (OR) for developing HCC were as follows:

o      3 to < 4 log₁₀ IU/mL: OR 1.38;

o      4 to < 5 log₁₀ IU/mL: OR 3.67;

o      5 to < 6 log₁₀ IU/mL: OR 5.30;

o      6 log₁₀ IU/mL or higher: OR 3.03.

"HBV-related HCC patients had higher HBV DNA level than non-HCC counterparts," the study authors concluded. "Our findings imply that active HBV replication is associated with the HCC development."

HCC patients had higher serum HBV DNA than patients without liver cancer, especially in the age ranges of 50-59 years or less than 40 years, they elaborated in their discussion.

Our results, they added, "suggest that patients with higher than 10⁴ IU/mL HBV DNA" are at more risk of developing HCC.

Investigator affiliations: Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China.

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Reference

JY Zhou, L Zhang, L Li, et al. HighHepatitis B virus load is associated with hepatocellular carcinomas development in Chinese chronic hepatitis B patients: a case control study. Journal of Virology. January 13, 2012 (Epub ahead of print).