The researchers determined the relation between positivity for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) and the development of hepatocellular carcinoma.
The findings of the study were reported in the latest issue of the New England Journal of Medicine.
The presence of HBeAg in serum indicates active viral replication in hepatocytes. HBeAg is thus a surrogate marker for the presence of hepatitis B virus DNA.
In 1991 and 1992, 11,893 men (age range, 30 to 65 years) were enrolled in the trial. All were without evidence of hepatocellular carcinoma and were from 7 townships in Taiwan.
Serum samples obtained at the time of enrollment were tested for HBsAg and HBeAg by radioimmunoassay.
The diagnosis of hepatocellular carcinoma was ascertained through data linkage with the computerized National Cancer Registry in Taiwan and with death certificates.
|Relative risk of HCC:|
Positive for HBsAg and HBeAg: 60.2
Positive for HBsAg alone: 9.6
| New England Journal of Medicine |
The authors determined the relative risk of hepatocellular carcinoma among men who were positive for HBsAg alone or for HBsAg and HBeAg, as compared with those who were negative for both.
There were found to be 111 cases of newly diagnosed hepatocellular carcinoma during 92,359 person-years of follow-up.
The incidence rate of hepatocellular carcinoma was 1169 cases per 100,000 person-years among men who were positive for both HBsAg and HbeAg.
For those were positive for HBsAg only and those who were negative for both, the incidence rates were 324 per 100,000 person-years and 39 per 100,000 person-years, respectively.
After adjustment for a number of confounding factors, the relative risk of hepatocellular carcinoma was 60.2 among those who were positive for both HBsAg and HBeAg, as compared with men who were negative for both.
The relative risk among men who were positive for HBsAg alone was 9.6.
Hwai-I Yang, of the College of Public Health at the National Taiwan University, Taipei, concluded on behalf of the group, "Positivity for HBeAg is associated with an increased risk of hepatocellular carcinoma."