Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa
نویسندگان
چکیده
The main objectives of this study were to define the occurrence and levels of hepatitis B virus (HBV) DNA in asymptomatic HBV carriers, cirrhosis patients and hepatocellular carcinoma (HCC) cases from The Gambia, and to evaluate the risk for cirrhosis or HCC associated with HBV viremia. We used sensitive real-time quantitative PCR assays to measure HBV DNA in samples from a case-control study consisting of 60 asymptomatic HBV carriers, 53 cirrhotic patients and 129 HCC cases. Logistic regression was used to estimate the risks of cirrhosis and HCC associated with HBV-DNA levels and HBV e antigenemia (HBeAg) detection (a surrogate marker for viral replication). Detectable HBV viremia and HBeAg positivity were both significantly associated with cirrhosis (increasing risk by fourfold and 11-fold respectively) and with HCC (increasing risk by sixfold and threefold respectively). HBV-DNA levels were significantly higher in both HCC cases and cirrhotic patients compared to asymptomatic carriers (P < 0.01 for both). High-level HBV DNA (>10,000 copies/mL) was strongly associated with both HCC and cirrhosis (17- and 39-fold increased risk). Lower level HBV viremia (200-10,000 copies/mL) conferred a significant risk of HCC, although the association with cirrhosis was not significant. In conclusion, we find that high HBV-DNA levels are strongly associated with the serious sequelae of HBV infection, independent of HBeAg status. While risk for cirrhosis and for HCC notably increases at HBV-DNA levels >or=10,000 copies/mL, low-level viremia was also associated with significant risk for HCC.
منابع مشابه
Age at Establishment of Chronic Hepatitis B Infection as a Risk Factor for Persistent Viral Replication, Liver Fibrosis and Hepatocellular Carcinoma in The Gambia, West Africa
متن کامل
Evaluation of serum AFP (α-fetoprotein) level in HBsAg carrier patients for diagnosis of hepatocellular carcinoma
Background: Hepatocellular carcinoma (HCC) is common all over the world as well as Iran. The incidence of HCC is higher in hepatitis B carriers and it is highly recommended to periodically screen these patients by serum alpha-fetoprotein (AFP) and liver ultrasound (US) every 6 months. We explore the diagnostic accuracy and the performance of (AFP) in cases of hepatitis B carriers as a scree...
متن کاملGut Microbiota and Chronic Hepatitis B and C Viruses-Induced Cirrhosis
Hepatitis B and C viruses are major public health problems. These viruses can chronically lead to liver disease such as fibrosis, cirrhosis, and hepatocellular carcinoma, which often increase mortality in these patients. According to previous studies, the liver is highly affected by changes in the microbiota of gastrointestinal tract and immune system damage caused by inflammation due to viral ...
متن کاملHepatitis B viral load and risk of HBV-related liver disease: from East to West?
Chronic hepatitis B has a variable course in disease activity with a risk of clinical complications like liver cirrhosis and hepatocellular carcinoma. As clinical symptoms present in a late stage of the disease, identification of risk factors is important for early detection and therefore improvement of prognosis. Recently, two REVEAL-HBV studies from Taiwan have shown a positive correlation be...
متن کاملKIR content genotypes associate with carriage of hepatitis B surface antigen, e antigen and HBV viral load in Gambians
BACKGROUND Hepatocellular carcinoma (HCC) causes over 800,000 deaths worldwide annually, mainly in low income countries, and incidence is rising rapidly in the developed world with the spread of hepatitis B (HBV) and C (HCV) viruses. Natural Killer (NK) cells protect against viral infections and tumours by killing abnormal cells recognised by Killer-cell Immunoglobulin-like Receptors (KIR). Thu...
متن کامل