Precore/basal core promoter mutants and hepatitis B viral DNA levels as predictors for liver deaths and hepatocellular carcinoma
Journal
World Journal of Gastroenterology
Journal Volume
12
Journal Issue
41
Pages
6620-6626
Date Issued
2006
Author(s)
Abstract
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 log10 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 = 0.021 and presence of basal core promoter mutants [odds ratio: 2.93 (1.24-7.57); P = 0.02] were independent predictors for progression to henatocellular 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. ? 2006 The WJG Press. All rights reserved.
Subjects
Basal core promoter mutants; Hepatitis B e antigen; Hepatitis B viral DNA; Hepatitis B viral genotypes; Hepatocellular carcinoma; Liver failure; Precore mutants
SDGs
Other Subjects
alpha fetoprotein; hepatitis B(e) antibody; hepatitis B(e) antigen; virus DNA; adult; age; article; Asian; computer assisted tomography; controlled study; death; disease association; disease course; echography; esophagus varices bleeding; female; follow up; gene mutation; genotype; hepatitis B; Hepatitis B virus; human; liver biopsy; liver cell carcinoma; liver failure; logistic regression analysis; major clinical study; male; multivariate analysis; nuclear magnetic resonance imaging; nucleotide sequence; prediction; promoter region; race difference; real time polymerase chain reaction; sepsis; sex ratio; univariate analysis; virus mutant
Publisher
Baishideng Publishing Group Co
Type
journal article