Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa.
Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa.
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DOI：
10.1111/j.1365-2893.2009.01168.x
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发表时间：
2010-02-01
影响因子：
2.5
通讯作者：
Kirk GD
中科院分区：
文献类型：
--
作者：
Mendy ME;Welzel T;Lesi OA;Hainaut P;Hall AJ;Kuniholm MH;McConkey S;Goedert JJ;Kaye S;Rowland-Jones S;Whittle H;Kirk GD
本研究的主要目的是确定冈比亚无症状HBV携带者、肝硬化患者和肝细胞癌（HCC）病例中B型肝炎病毒（HBV）DNA的发生率和水平，并评估与HBV病毒血症相关的肝硬化或HCC风险。我们采用敏感的实时定量PCR检测了60例无症状HBV携带者、53例肝硬化患者和129例肝癌患者的病例对照研究样本中的HBV DNA。Logistic回归用于估计肝硬化和HCC与HBV-DNA水平和HBV-e抗原血症（HBeAg）检测（病毒复制的替代标志物）相关的风险。可检测的HBV病毒血症和HBeAg阳性与肝硬化（分别增加4倍和11倍）和HCC（分别增加6倍和3倍）显著相关。HCC患者和肝硬化患者的HBV-DNA水平均显著高于无症状携带者（P<0.01）。高水平HBV DNA（>10 000拷贝/mL）与HCC和肝硬化（风险增加17倍和39倍）密切相关。较低水平的HBV病毒血症（200-10 000拷贝/mL）赋予HCC显著的风险，尽管与肝硬化的相关性不显著。总之，我们发现高HBV-DNA水平与HBV感染的严重后遗症密切相关，与HBeAg状态无关。当HBV-DNA水平≥10 000拷贝/mL时，肝硬化和HCC的风险显著增加，低水平病毒血症也与HCC的显著风险相关。
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.
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影响因子：
10.4
作者：
Kuniholm MH;Lesi OA;Mendy M;Akano AO;Sam O;Hall AJ;Whittle H;Bah E;Goedert JJ;Hainaut P;Kirk GD
通讯作者：
Kirk GD
影响因子：
120.7
作者：
Chen, CJ;Yang, HI;Iloeje, UH
通讯作者：
Iloeje, UH
影响因子：
13.5
作者：
Kirk, GD;Lesi, OA;Montesano, R
通讯作者：
Montesano, R
影响因子：
29.4
作者：
Iloeje, UH;Yang, HI;Chen, CJ
通讯作者：
Chen, CJ
影响因子：
8
作者：
Kirk, GD;Lesi, OA;Montesano, R
通讯作者：
Montesano, R