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Individual and combined effects of hepatitis B surface antigen level and viral load on liver cancer risk
Author(s) -
Yang Yang,
Gao Jing,
Tan YuTing,
Li HongLan,
Wang Jing,
Ma Xiao,
Zheng Wei,
Shu XiaoOu,
Xiang YongBing
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14032
Subject(s) - medicine , hbsag , hepatitis b virus , odds ratio , gastroenterology , confidence interval , viral load , hepatitis b , population , liver cancer , cancer , immunology , virus , environmental health
Background Hepatitis B surface antigen (HBsAg) and viral load are both hallmarks of hepatitis B virus (HBV) infection and have potential to stratify liver cancer risk. Methods We carried out a nested case–control study including 211 liver cancer cases and 221 controls who were seropositive for HBsAg within two population‐based cohorts in Shanghai. Logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Results Risk of liver cancer was positively related to increasing levels of HBV‐DNA and HBsAg in dose–response manners. Compared with subjects with HBV‐DNA < 2000 IU/ml, the adjusted ORs increased from 2.11 (95%CI: 0.99–4.50) to 10.47 (95%CI: 5.06–21.68) for those with HBV‐DNA level at 2000–19 999 to ≥ 20 000 IU/ml. Compared with subjects at a low level of HBsAg (0.05–99 IU/ml), the adjusted ORs increased from 1.82 (95%CI: 0.90–3.68) to 2.21 (95%CI: 1.10–4.43) for those with HBsAg level at 100–999 to ≥ 1000 IU/ml. Compared with subjects with HBV‐DNA < 2000 IU/ml and HBsAg < 100 IU/ml, the adjusted ORs were increased from 2.20 (95%CI: 1.07–4.49) for those with HBV‐DNA < 2000 and HBsAg ≥ 100 IU/ml to 6.94 (95%CI: 3.39–14.23) for those with HBV‐DNA ≥ 2000 IU/ml and HBsAg < 1000 IU/ml, and 16.15 (95%CI: 7.60–34.32) for those with HBV‐DNA ≥ 2000 IU/ml and HBsAg ≥ 1000 IU/ml. Conclusion Elevated levels of HBV‐DNA and HBsAg are associated with increased risks of liver cancer. Chronic HBsAg carriers may be suggested to simultaneously lower the viral load to < 2000 IU/ml and HBsAg level to < 100 IU/ml to lower their liver cancer risk.