Hepatitis B Virus Replication in Southern African Blacks with HBsAg‐Positive Hepatocellular Carcinoma

Sera from 106 southern African blacks with hepatocellular carcinoma and hepatitis B surface antigenemia (HBsAg) were tested for hepatitis B viral DNA (HBV‐DNA) activity, HBV‐DNA polymerase concentrations, and HBV e antigen (HBeAg) and antibody (anti‐HBe) to investigate the state of viral replication in these patients. HBeAg and anti‐HBe were detected by radioimmunoassay, HBV‐DNA by molecular hybridization using a 32p‐labeled HBV‐DNA probe, and HBV‐DNA polymerase was measured by incorporation of 3H‐labeled thymidine triphosphate into double‐stranded HBV‐DNA. HBeAg was present in 30.2% (32/106) of the patients, almost always in low titer; 63.8% of the patients were anti‐HBe positive. Circulating HBV‐DNA was detected in 18.8% (20/106) of patients, including 14 of 32 (43.7%) who were HBeAg positive and 6 of 74 (8.1%) who were anti‐HBe positive. In most patients, only trace amounts of HBV‐DNA were evident. Raised HBV‐DNA polymerase activity was found in 5.6% (6/106) of the patients, all of whom were HBeAg positive and 4 of whom had detectable amounts of circulating HBV‐DNA. The HBV‐DNA polymerase activity was relatively low in these patients. HBV replication thus appears to be present in only a minority of southern African Blacks with HBV‐related hepatocellular carcinoma, and when