Reuters Health Information (2005-02-18): Hepatitis B viral load, genotype affect risk of liver cancer
Hepatitis B viral load, genotype affect risk of liver cancer
Last Updated: 2005-02-18 12:57:16 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Prospective study findings
indicate that blood hepatitis B virus DNA levels and genotype are
important markers for defining high-risk patients for antiviral
treatment among HBV carriers 30 years of age or older.
According to the study, published in the February 16th issue of the
Journal of the National Cancer Institute, higher plasma HBV DNA levels
and infection with HBV genotype C are independently and additively
associated with an increased risk of hepatocellular carcinoma (HCC).
"HBV is probably the etiological agent for approximately 60% of all
HCCs," Dr. Ming-Whei Yu from National Taiwan University in Taipei noted
in comments to Reuters Health. "The HCC risk is 20-fold higher for HBV
carriers than for HBV noncarriers, but only a fraction of HBV carriers
are expected to develop HCC in their lifetime."
In a long-term follow-up study of 4841 Taiwanese male HBV carriers
age 30 years or older, Dr. Yu's team found that men with blood HBV DNA
levels of 4.23 log10copies/mL or greater had between a two- to
seven-fold higher risk of developing HCC than those with blood HBV DNA
levels of 3.62 log10copies/mL or less.
Additionally, infection with HBV genotype C was associated with an
approximately five-fold increased risk for HCC compared with infection
with other genotypes (almost all type B). Moreover, there was an
additive effect between HBV DNA levels and genotype.
For example, men infected with genotype C HBV and HBV DNA levels
greater than 5.90 log10copies/mL had a 26.5-fold higher risk of HCC
than men with other HBV genotypes and HBV DNA levels less than 4.23
"The observation that HBV carriers with HBV DNA levels greater than
4.22 log10 copies/mL have at least a two-fold excess risk of HCC
compared with HBV carriers with lower HBV DNA levels provides
information to define a virologic response representing the long-term
clinical improvement for future anti-HBV therapy," Dr. Yu told Reuters
In an editorial, Dr. James J. Goedert from the National Cancer
Institute in Bethesda, Maryland says this study "provides strong
evidence that HBV genotypes matter."
"Despite advances in pharmacology, virology, and epidemiology,
challenges to reducing HCC incidence and mortality abound," he writes.
"The slow, but sure, approach to reducing liver cancer mortality
over the next 50 years is primary prevention of HCC by universal HBV
vaccination," he contends.
J Natl Cancer Inst 2005;97:245-246,265-272.