Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa

Abstract

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 ≥10 000 copies/mL, low-level viremia was also associated with significant risk for HCC.

Anti-hepatitis B Virus Activities of Cinobufacini and Its Active Components Bufalin and Cinobufagin in HepG2.2.15 Cells

“…Cytotoxicity Assay HepG2.2.15 cells were seeded in 96-well plates at a density of 1.5ϫ10 4 per well and respectively treated with cinobufacini (1,10,20, 50, 100, or 215 mg/ml), bufalin (10 Measurement of HBV Antigens HepG2.2.15 cells were seeded in 6-well plates at a density of 4.5ϫ10 5 per well for measurement of HBV antigens, HBV DNA, and HBV RNA. After incubation with various concentrations of cinobufacini, bufalin, cinobufagin, or 3TC for 3 or 6 d, the culture medium was collected, cell debris was removed, and the result was stored at Ϫ70°C until analysis.…”

Follow-Up of Chronic Hepatitis B Carriers: A Cross-Sectional Descriptive-Analytical Study

“…Similarly, an earlier study indicated that compared with HBeAg-negative and female individuals, liver disease was significantly more severe among HBeAg-positive and male individuals, respectively (19). Another study also reported a significant correlation between HBeAg positivity and HBV infection complications, such as cirrhosis and hepatocellular carcinoma (20). All these findings confirm that HBeAg positivity is correlated with hepatitis progression and severity.…”

Genetic Factors, Viral Infection, Other Factors and Liver Cancer: An Update on Current Progress

“…Similarly, a research performed in Hong Kong (Chan et al, 2008) also reported positive association between high HBV load and HCC risk with a hazard ratio of 1.62 among Hong Kong population. A research conducted in Gambia found that, the high HBV DNA levels were strongly associated with HCC and the OR reached 38.8 after adjustment (Mendy et al, 2010), and more and more evidence demonstrated that the suppression of HBV may significantly reduce the risk of HCC. Interestingly, HBV load has no significant difference between patients with early HCC and those with non-early HCC (Chu et al, 2012), however, the positive association of higher load and cancer risk remained constant when being compared with previous studies.…”