Spontaneous clearance of high-titer serum HBV DNA and risk of hepatocellular carcinoma in a Chinese population
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Chronic hepatitis B virus (HBV) carriers with high-titer viremia (>105 virions/ml) are at increased risk for hepatocellular carcinoma (HCC). The aim of this study was to determine the relationship between clearance of high-titer viremia and subsequent risk of HCC. The study population was a prospective cohort of 114 adults from Haimen City, China, all HBV DNA(+) at study entry and followed for 797.8 person-years in total. During follow-up, 54 (47.4%) subjects spontaneously cleared high-titer viremia at least once. Of these, 27 were considered to have undergone stable seroconversion, 16 were considered unstable (12 reversions to HBV DNA positivity and 4 multiple clearances), and 11 did not have sufficient follow-up to determine stability. Of the 114 persons, 26 (22.8%) died during follow-up, 21 (18.4%) from HCC. Using Cox proportional hazards models, the RR of HCC death associated with seroconversion was 2.8 (95% CI = 1.1–7.4), controlling for age, sex, family HCC history, history of acute hepatitis, alcohol use and cigarette smoking. In conclusion, fluctuations of high-titer viremia may indicate increased hepatocellular damage and at least short-term increases in HCC risk. Long-term longitudinal studies are needed to clarify this relationship and its potential usefulness as a prognostic marker in chronic HBV infection.
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- Spontaneous clearance of high-titer serum HBV DNA and risk of hepatocellular carcinoma in a Chinese population
Cancer Causes & Control
Volume 14, Issue 10 , pp 995-1000
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers
- Additional Links
- Cox proportional hazards regression
- HBV DNA
- hepatitis B virus
- hepatocellular carcinoma
- risk factors
- viral load
- Industry Sectors
- Author Affiliations
- 1. Division of Population Science, Fox Chase Cancer Center, Philadelphia, PA, USA
- 2. Haimen City Centers for Disease Control, Haimen City, PR China
- 3. Fudan University School of Public Health, Shanghai, PR China
- 4. Division of Population Science, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA