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Viral load is a significant prognostic factor for hepatitis B virus-associated hepatocellular carcinoma
Kazuaki Ohkubo1, Yuji Kato, Tatsuki Ichikawa
1First Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Insights
Hepatitis B virus (HBV) DNA levels and tumor size are key indicators for predicting the prognosis of patients with HBV-associated liver cancer (HCC). Lower viral load is linked to better survival outcomes in HCC patients.
Area of Science:
- Hepatology
- Virology
- Oncology
Background:
- Hepatitis B virus (HBV) infection is a significant risk factor for hepatocellular carcinoma (HCC).
- Identifying prognostic factors in HBV-associated HCC is crucial for patient management.
- Multivariate analysis is employed to determine independent predictors of survival.
Purpose of the Study:
- To identify prognostic factors in patients diagnosed with HBV-associated HCC.
- To evaluate the significance of various clinical and laboratory parameters on patient survival.
Main Methods:
- A cohort of 74 patients with HBV-associated HCC was analyzed.
- Patients received diverse treatments including surgical resection, non-surgical interventions, or observation.
- Prognostic factors such as age, gender, HBV-DNA levels, tumor characteristics, and clinical stage were assessed.
Main Results:
- The 5-year survival rate for HBV-associated HCC was 21%.
- Multivariate analysis revealed serum HBV-DNA level and tumor size as significant independent prognostic factors.
- Lower HBV viral load correlated with improved survival, irrespective of hepatitis B e antigen status.
Conclusions:
- Serum HBV-DNA level serves as a valuable prognostic marker for HBV-related HCC.
- Patients with poorer prognosis may exhibit inefficient viral clearance or higher virus production.
- Tumor size is also a critical determinant of survival in HBV-associated HCC.
Background:
Hepatitis B virus (HBV) is closely linked to hepatocellular carcinoma (HCC). The objective of the current study was to identify the factors involved in the prognosis of patients with HBV-associated HCC using multivariate analysis.
Methods:
The current study included 74 patients with HBV-associated HCC who were admitted to Nagasaki University Hospital, Nagasaki, Japan, between 1983-1998. Of these, 13 patients underwent surgical tumor resection; 43 patients received nonsurgical treatment with transcatheter arterial embolization, percutaneous ethanol injection, or both; and 18 patients were followed without any active treatment. The significance of the patient's age; gender; history of blood transfusion; alcohol use; serum levels of alanine aminotransferase, alpha-fetoprotein, and HBV-DNA; number and size of liver tumors; clinical stage; and histologic diagnosis of HCC as prognostic factors was evaluated using univariate and multivariate analyses.
Results:
The 3-year, 5-year, and 10-year postdiagnosis cumulative survival rates were 36%, 21%, and 17%, respectively. Multivariate analysis identified the level of serum HBV-DNA and tumor size at diagnosis as independent and significant prognostic factors (P = 0.0022 and P = 0.0106, respectively). In addition, a low level of viremia was found to be associated with longer survival (P = 0.0057) even in patients who were negative for the hepatitis B e antigen.
Conclusions:
The results of the current study suggest that viral load is a useful prognostic marker for HBV-related HCC and that HCC patients with a less favorable course appear either to clear the virus poorly or to have a greater level of virus production.