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Updated: May 25, 2026
Real-Time Polymerase Chain Reaction-Based Detection and Quantification of Hepatitis B Virus DNA
Published on: December 15, 2023
Quantitative HBV DNA and AST are strong predictors for survival after HCC detection in chronic HBV patients
C D M Witjes1, J N M IJzermans, A A van der Eijk
1Department of Hepatobiliary and Transplantation Surgery, Erasmus MC, University Medical Centre Rotterdam, the Netherlands.
Insights
High hepatitis B viral load (HBV DNA) at hepatocellular carcinoma (HCC) detection is linked to poorer survival. Lowering HBV DNA may improve outcomes for HCC patients.
Area of Science:
- Hepatology
- Oncology
- Virology
Background:
- Hepatitis B virus (HBV) infection is a significant risk factor for hepatocellular carcinoma (HCC).
- The impact of quantitative HBV DNA levels at the time of HCC diagnosis on patient survival remains an area of investigation.
Purpose of the Study:
- To investigate the association between quantitative HBV DNA levels at HCC detection and overall survival in HCC patients.
- To determine if HBV viral load influences prognosis in patients diagnosed with HCC.
Main Methods:
- Retrospective analysis of 597 HCC cases diagnosed between 2000-2008, including 98 with HBV.
- Patients were categorized into high (HBV DNA ≥10(5) copies/ml) and low (HBV DNA <10(5) copies/ml) viral load groups.
- Univariate and multivariate analyses were used to evaluate clinical and virological factors affecting survival.
Main Results:
- Patients with high HBV DNA viral load exhibited more HBeAg-positive status, lower serum albumin, and higher AST/ALT levels.
- One- and five-year survival rates were significantly lower for HCC patients with high viral load (58% and 11%) compared to low viral load (70% and 35%).
- Multivariate analysis identified higher AST levels and higher HBV DNA viral load as independent predictors of shorter overall survival.
Conclusions:
- HBV DNA level at HCC detection is a significant prognostic factor for overall survival.
- Elevated HBV DNA is associated with specific clinical markers like HBeAg positivity, low albumin, and high AST/ALT.
- These findings suggest that suppressing HBV DNA through nucleoside analogue therapy post-HCC detection may enhance patient survival.
Abstract:
Hepatitis B virus infection (HBV) is an important co-factor in the development of hepatocellular carcinoma (HCC). We studied whether quantitative HBV DNA at time of HCC detection influences survival of HCC patients. All diagnosed HCC cases between 2000 and 2008 at our university-based reference centre were analysed to determine the influence of hepatitis B viral load on overall survival. Clinical and virological findings were evaluated in univariate and multivariate analyses, survival rates were assessed for HCC patients with a high viral load (HBV DNA ≥10(5) copies/ml) and low viral load (HBV DNA <10(5) copies/ml). HCC was diagnosed in 597 patients, including 98 patients with HBV. The group of 37 patients (38%) who had a high viral load contained more HBeAg-positive patients, had lower serum albumin levels and higher serum aspartate aminotransferase (AST ) and alanine aminotransferase (ALT ) levels. The one- and five-year survival rates of HCC patients with a high viral load were 58% and 11% and for HCC patients with a low viral load 70% and 35%, respectively. In multivariate analysis a higher AST level and higher viral load were significantly associated with shorter overall survival (HR=2.30; p=0.018, HR=1.22; p=0.015, respectively). HBeAg positivity, low albumin level or high AST or ALT levels in HCC patients are associated with a higher HBV DNA . HBV DNA level at detection is associated with overall survival of HCC patients. These findings support the concept that after HCC detection adequate suppression of HBV DNA by nucleoside analogue therapy may improve survival.
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