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World J Gastroenterol. May 21, 2008; 14(19): 3059-3063
Published online May 21, 2008. doi: 10.3748/wjg.14.3059
A case-control study of the relationship between hepatitis B virus DNA level and risk of hepatocellular carcinoma in Qidong, China
Tao-Tao Liu, Ying Fang, Hui Xiong, Tao-Yang Chen, Zheng-Pin Ni, Jian-Feng Luo, Nai-Qing Zhao, Xi-Zhong Shen
Tao-Tao Liu, Xi-Zhong Shen, Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Ying Fang, Endoscopy Center, Huadong Hospital, Fudan University, Shanghai 200040, China
Hui Xiong, Chinese National Human Genome Center at Shanghai, Shanghai 201203, China
Tao-Yang Chen, Zheng-Pin Ni, Qidong Liver Cancer Institute, Qidong 226200, Jiangsu Province, China
Jian-Feng Luo, Nai-Qing Zhao, Department of Health Statistics and Community Medicine, Fudan University, Shanghai 200032, China
Author contributions: Liu TT, Xiong H and Shen XZ designed the research; Liu TT and Fang Y performed the research; Chen TY and Ni ZP contributed samples and materials; Zhao NQ and Ruo JF analyzed the data; and Liu TT and Shen XZ wrote the paper.
Correspondents: Professor Xi-Zhong Shen, MD, Department of Gastroenterology, Zhongshan Hospital, Fudan University, 180# Fenglin Road, Shanghai 200032, China. shenxz99@yahoo.com
Telephone: +86-21-64041990
Fax: +86-21-64038038
Received: December 4, 2007
Revised: February 25, 2008
Published online: May 21, 2008
Abstract

AIM: To investigate the role of hepatitis B virus (HBV) replication in the development of hepatocellular carcinoma (HCC), a nested case-control study was performed to study the relationship between HBV DNA level and risk of HCC.

METHODS: One hundred and seventy cases of HCC and 276 control subjects free of HCC and cirrhosis were selected for this study. Serum HBV DNA level was measured using fluorescein quantitative polymerase chain reaction at study entry and the last visit.

RESULTS: In a binary unconditional logistic regression analysis adjusted for age, cigarette smoking, alcohol consumption and family history of chronic liver diseases, the adjusted odds ratios (95% confidence intervals) of HCC in patients with increasing HBV DNA level were 2.834 (1.237-6.492), 48.403 (14.392-162.789), 42.252 (14.784-120.750), and 14.819 (6.992-31.411) for HBV DNA levels ≥ 104 to < 105; ≥ 105 to < 106; ≥ 106 to < 107; ≥ 107 copies/mL, respectively. Forty-six HCC cases were selected to compare the serums viral loads of HBV DNA at study entry with those at the last visit. The HBV DNA levels measured at the two time points did not differ significantly.

CONCLUSION: The findings of this study provide strong longitudinal evidence of an increased risk of HCC associated with persistent elevation of serum HBV DNA level in the 104-107 range.

Keywords: Hepatitis B surface antigen; Viral replication; Asymptomatic carriers; Viral load