Precore/basal core promoter mutants and hepatitis B viral DNA levels as predictors for liver deaths and hepatocellular carcinoma

• Published in: World journal of gastroenterology : WJG 2006-11, Vol.12 (41), p.6620-6626
• Main Authors: Tong, Myron J, Blatt, Lawrence M, Kao, Jia-Horng, Cheng, Jason Tzuying, Corey, William G
• Format: Article
• Language: English
• Subjects: Adult; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - virology; Disease Progression; DNA, Viral - blood; DNA, Viral - genetics; Female; Genotype; Hepatitis B - complications; Hepatitis B e Antigens - blood; Hepatitis B virus - genetics; Humans; Liver Cancer; Liver Failure - blood; Liver Failure - mortality; Liver Failure - virology; Liver Neoplasms - blood; Liver Neoplasms - virology; Logistic Models; Male; Middle Aged; Multivariate Analysis; Mutation; Odds Ratio; Predictive Value of Tests; Promoter Regions, Genetic; Retrospective Studies; 乙型病毒肝炎; 肝坏死
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v12.i41.6620

AIM： To conduct a retrospective study in 400 chronic hepatitis B patients in order to identify hepatitis B viral factors associated with complications of liver disease or development of hepatocellular carcinoma. METHODS： The mean follow-up time was 83.6 ± 39.6 mo. Alpha-fetoprotein test and abdominal ultrasound were used for cancer surveillance. Hepatitis B basal core promoter mutants, precore mutants, genotypes, hepatitis B viral DNA （HBV DNA） level and hepatitis B e antigen （HBeAg） were measured. Univariate analysis and logistic regression were used to assess odds ratios for viral factors related to liver deaths and hepatocellular carcinoma development. RESULTS： During follow-up, 38 patients had liver deaths not related to hepatocellular carcinoma. On multivariate analysis, older age [odds ratio： 95.74 （12.13-891.31）, P 〈 0.0001], male sex [odds ratio： 7.61 （2.20-47.95）; P = 0.006], and higher Iogzo HBV DNA [odds ratio： 4.69 （1.16-20.43）; P 〈 0.0001] were independently predictive for these liver related deaths. Also, 31 patients developed hepatocellular carcinoma. Multivariate analysis showed that older age [odds ratio： 26.51 （2.36-381.47）; P = 0.007], presence of precore mutants [odds ratio： 4.23 （1.53-19.58）, P = 0.02] and presence of basal core promoter mutants [odds ratio： 2.93 （1.24-7.57）; P = 0.02] were independent predictors for progression to hepatocellular carcinoma. CONCLUSION： Our results show that high levels of baseline serum HBV DNA are associated with non- hepatocellular carcinoma-related deaths of liver failure, while genetic mutations in the basal core promoter and precore regions are predictive for development of hepatocellular carcinoma.