HEPATITIS-B VIRUS-DNA IN PERIPHERAL-BLOOD LEUKOCYTES - A COMPARISON BETWEEN HEPATOCELLULAR-CARCINOMA AND OTHER HEPATITIS-B VIRUS-RELATED CHRONIC LIVER-DISEASES

Background. Hepatitis B virus (HBV) DNA has been detected in the perip heral blood leukocytes (PBL) during acute and chronic HBV infection. P ossible pathobiologic significance includes infectivity and altered im munity. There are few data relating PBL HBV-DNA with severity of the l iver disease, in particular with hepatocellular carcinoma (HCC). Metho ds. HBV-DNA was detected by dot-spot hybridization technique in PBL se parated from venous blood samples of 209 hepatitis B surface antigen-p ositive patients (28 healthy carriers and 95 chronic hepatitis, 29 cir rhotic, and 57 HCC patients). Serum HBV-DNA and hepatitis B e-antigen (HBeAg) were also measured.Results. Thirty percent of HCC patients wer e hepatitis e-antigen-positive compared to 50%, 84% (P < 0.0001), and 69% (P < 0.00001) of healthy carriers and chronic hepatitis and cirrho tic patients, respectively. Furthermore, only 11% of HCC patients had detectable serum HBV-DNA compared to 39% (P < 0.001), 58% (P < 0.001), and 31% (P < 0.05) of these respective patient groups. Despite low vi ral replication among HCC patients, 58% had PBL HBV-DNA. Corresponding figures for healthy carriers and for chronic hepatitis and cirrhotic patients were 39%, 58%, and 56%. Fifty-two percent of HCC patients had positive PBL HBV-DNA in the absence of serum HBV-DNA, compared with 2 5% in healthy carriers (P < 0.05) and 22% in chronic hepatitis (P < 0. 001) and 35% in cirrhotic patients (P = NS). Conclusion. The high dete ction rate of PBL HBV-DNA among HCC patients may reflect certain patho genetic processes of HBV infection and indicate a higher risk of devel opment of HCC.