A prospective study of the relationship between serum hepatitis B virus DNA and the risk of primary liver cancer

Objective To determine the relationship between the seHlm hepatitis B virus(HBV)DNA and the risk of primary liver cancer(PLC).Methods Farmers aged 30-55 years in Long An county were recruited in this study Blood samples were collected and the sera were tested for HBsAg using EnzymeLinked ImmunoSorbent Assay(ELISA),and the HBsAg-positive sera were further tested for viral DNA using nested polymerase chain reaction(nPCR).The smdy subjects were divided into three groups.The first group was positive for both HBsAg and HBV DNA.The second group was positive for HBsAg but negative for HBV DNA.Age-,sex-,residence-matched HBsAg negative controls for group 1 and group 2 were enrolled in the third group.The cohort was followed up for four years.Results The positive rate of HBsAg in these farmers was 14.52%(3975/27 379),and the HBV DNA positive rate in HBsAg posirive Srbjects was 40.35%(1604/3975).The total PLC incidence rate in Group 1 and 2 was 672.45/100 000 person-years(PY),significantly higher than that in Group3(17.19/100 000 PY).The relative risk(RR)was 39.123,and the 95%confidence interval(C,)was 9.018-159.146.The PLC incidence rate of Group 1(984.03/100 000 PY)Was significantly higher than that of Group2(324.38/100 000 PY).The RR was 3.034,and the 95%CI was 1.795-5.125.Multivariate analyses of nGroupl and 2 with Cox model showed that sex,age,serum HBV DNA,and family history of PLC were independent risk factors of PLC.Conclusion HBV DNA and HBsAg positive subjects have a higher chance to develop PLC than HBV DNA negative,HBsAg positive subjects. Key words: Hepatitis B virus; Hepatitis B surface antigens; DNA; viral; Liver neoplasms; Prospective cohort study