Humans chronically infected with hepatitis B virus (HBV) are at further risk of liver cancer upon exposure to dietary aflatoxin B1 (AFB1), a carcinogenic product of the mold Aspergillus flavus. For the present study, we utilized double-transgenic mice (ATX mice) that express the HBV X protein (HBx) and possess a bacteriophage lambda transgene to evaluate the in vivo effect of HBx expression on AFB1-induced DNA mutations. The expression of HBx correlated with a 24% increase in mutation frequency overall and an approximately twofold increase in the incidence of G/C-to-T/A transversion mutations following AFB1 exposure. These results are consistent with a model in which expression of HBx during chronic HBV infection may contribute to the development of hepatocellular carcinoma following exposure to environmental carcinogens.Chronic infection with hepatitis B virus (HBV) is a primary risk factor for the development of hepatocellular carcinoma (HCC) (2, 49). Additional risk factors include chemical agents, such as aflatoxin and ethanol, which can result in liver damage upon repeated exposure (7,56,58). Epidemiological data, as well as experimental studies utilizing transgenic animals, have indicated that chronic HBV infection and exposure to hepatocarcinogens act synergistically in the development of HCC (10,14,31,33,46,50,53,57). However, the mechanism by which chronic HBV infection sensitizes an individual to carcinogeninduced liver cancer remains unknown.The 17-kDa HBV X protein (HBx) is a nonstructural protein necessary for the establishment of hepadnaviral infection in woodchucks and presumably in all mammals (8, 59). Depending upon experimental conditions, HBx is reported to inhibit nucleotide excision repair (NER) (3,17,21,32,41), to influence apoptosis (11,23,39,40,52,54,55), and to induce cell cycle progression (4,26,27). By affecting these pathways, HBx could facilitate the mutagenic effects of hepatocarcinogens or promote the survival and proliferation of hepatocytes altered after exposure. Although transgenic mice that express HBx are more sensitive to the carcinogenic effects of the hepatocarcinogen diethylnitrosamine (DEN [10,33,50]), they do not demonstrate significant increases in overall mutation accumulation (32, 33). These results suggest that HBx contributes to DEN-mediated carcinogenesis by a mechanism that does not involve a dramatic inhibition of DNA repair. Recently, a study demonstrated that expression of HBx increased mutagenesis in a human liver cell line treated with aflatoxin B1 (AFB1) (17). The effect of HBx on AFB1-induced damage in vivo has not been examined.Aflatoxins are a family of potent hepatocarcinogens produced by the mold Aspergillus flavus. A common dietary contaminant in many parts of the world, aflatoxins are metabolized in vivo by cytochrome P450 isoenzymes to form mutagenic epoxides (13). The induction of P450 enzyme levels may explain the increased AFB1 sensitivity of mice that overexpress the hepatitis B surface antigen (24). However, the levels of carcinogen-metabolizin...