Infection with hepatitis B virus (HBV) is associated with the risk for nonliver cancer, particularly digestive system cancers, according to a study published in JAMA Network Open.1

HBV is one of the most serious and prevalent health conditions in the world, and the cause of up to 80% of cases of hepatocellular carcinoma, particularly in Chinese and African populations.2,3 A few clinical case studies have detected HBV in several types of nonliver tissues, suggesting that HBV may play a role in the oncogenesis of nonliver cancers.4-6 However, few population-based studies have observed associations between chronic HBV infection and various nonliver cancers7-11; therefore, researchers assessed the associations between chronic HBV infection and risk for all cancer types in a population-based study involving 496,732 Chinese individuals.1 They found that hepatitis B surface antigen (HBsAg) seropositivity (n=15,355) was associated with the risk for hepatocellular carcinoma (hazard ratio [HR], 15.77; 95% CI, 14.15-17.57), stomach cancer (HR, 1.41; 95% CI, 1.11-1.80), colorectal cancer (HR, 1.42; 95% CI, 1.12-1.81), oral cavity cancer (HR, 1.58; 95% CI, 1.01-2.49), pancreatic cancer (HR, 1.65; 95% CI, 1.03-2.65), and lymphoma (HR, 2.10; 95% CI, 1.34-3.31) compared with patients who were HBsAg seronegative (n=481,377). These associations were further validated in independent population- and tissue-based studies.

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The authors concluded that, “In a large prospective Chinese cohort of 496 732 adults, we found that participants who were HBsAg seropositive were at an increased risk of developing [hepatocellular carcinoma] and several nonliver cancers, including stomach cancer, oral cancer, colorectal cancer, pancreatic cancer, and lymphoma.”1


References
1. Song C, Lv J, Liu Y, et al. Associations between hepatitis B virus infection and risk of all cancer types. JAMA Network Open. 2019;2(6):e195718.

2. Liaw YF, Chu CM. Hepatitis B virus infection. Lancet. 2009;373(9663):582-592.

3. Arbuthnot P, Kew M. Hepatitis B virus and hepatocellular carcinoma. Int J Exp Pathol. 2001;82(2):77-100.

4. Dejean A, Lugassy C, Zafrani S, Tiollais P, Brechot C. Detection of hepatitis B virus DNA in pancreas, kidney and skin of two human carriers of the virus. J Gen Virol. 1984;65(pt 3):651-655.

5. Mason A, Wick M, White H, Perrillo R. Hepatitis B virus replication in diverse cell types during chronic hepatitis B virus infection. Hepatology. 1993;18(4):781-789.

6. Chen NL, Bai L, Deng T, Zhang C, Kong QY, Chen H. Expression of hepatitis B virus antigen and Helicobacter pylori infection in gastric mucosa of patients with chronic liver disease. Hepatobiliary Pancreat Dis Int. 2004;3(2):223-225.

7. Iloeje UH, Yang HI, Jen CL, et al. Risk of pancreatic cancer in chronic hepatitis B virus infection: data from the REVEAL-HBV cohort study. Liver Int. 2010;30(3):423-429.

8. Ulcickas Yood M, Quesenberry CP Jr, Guo D, et al. Incidence of non-Hodgkin’s lymphoma among individuals with chronic hepatitis B virus infection. Hepatology. 2007;46(1):107-112.

9. Andersen ES, Omland LH, Jepsen P, et al; DANVIR Cohort Study. Risk of all-type cancer, hepatocellular carcinoma, non-Hodgkin lymphoma and pancreatic cancer in patients infected with hepatitis B virus. J Viral Hepat. 2015;22(10):828-834.

10. Sundquist K, Sundquist J, Ji J. Risk of hepatocellular carcinoma and cancers at other sites among patients diagnosed with chronic hepatitis B virus infection in Sweden. J Med Virol. 2014;86(1):18-22.

11. Kamiza AB, Su FH, Wang WC, Sung FC, Chang SN, Yeh CC. Chronic hepatitis infection is associated with extrahepatic cancer development: a nationwide population-based study in Taiwan. BMC Cancer. 2016;16(1):861.