Elevated Levels of HBV DNA and HBsAg May Increase Liver Cancer Risk

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Risk of liver cancer was positively associated with increasing levels of HBV DNA and HBsAg in dose-response manners.
Risk of liver cancer was positively associated with increasing levels of HBV DNA and HBsAg in dose-response manners.

HealthDay News — Elevated levels of hepatitis B virus (HBV) DNA and hepatitis B surface antigen (HBsAg) are associated with increased risks of liver cancer, according to a study published in the Journal of Gastroenterology and Hepatology.

Yang Yang, from the Shanghai Jiaotong University School of Medicine in China, and colleagues assessed the potential of HBsAg and viral load to stratify liver cancer risk. They performed a nested case-control study in 211 liver cancer cases and 221 controls who were sero-positive for HBsAg within two population-based cohorts in Shanghai.

The researchers found that the risk of liver cancer was positively associated with increasing levels of HBV DNA and HBsAg in dose-response manners.The adjusted odds ratios [ORs] increased from 2.11 (95% CI, 0.99 to 4.5) to 10.47 (95% CI, 5.06 to 21.68) for those with HBV DNA level of 2000-19,999 IU/ml or ≥20,000 IU/ml compared with subjects with HBV DNA <2000 IU/ml. 

The adjusted ORs increased from 1.82 (95% CI, 0.9 to 3.68) to 2.21 (95% CI, 1.1 to 4.43) for those with HBsAg level at 100-999 IU/ml or ≥1000 IU/ml vs subjects at a low level of HBsAg (0.05 to 99 IU/ml). Adjusted ORs were increased from 2.2 (95% CI, 1.07 to 4.49) for those with HBV DNA <2000 IU/ml and HBsAg ≥100IU/ml to 6.94 (95% CI, 3.39 to 14.23) for those with HBV DNA ≥2000 IU/ml and HBsAg <1000 IU/ml and 16.15 for those with HBV DNA ≥2000 IU/ml and HBsAg ≥1000 IU/ml vs those with HBV DNA <2000 IU/ml and HBsAg <100 IU/ml.

"Chronic HBsAg carriers may be suggested to simultaneously lower the viral load to <2000 IU/ml and HBsAg level to <100 IU/ml to lower their liver cancer risk," conclude the authors.

Reference

Yang Y, Gao J, Tan YT, et al. Individual and combined effects of hepatitis B surface antigen level and viral load on liver cancer risk [published online October 24, 2017]. J Gastro Hep. doi: 10.1111/jgh.14032.

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