Hepatocellular carcinoma: Significance of HBV vertical transmission

In two cases of childhood hepatocellular carcinoma in Thailand, we establis hed vertical transmission of hepatitis B virus infection as the underlying cause. With the first patient, the family history of HBV carriage became ev ident and a pedigree could be devised which demonstrated the high prevalenc e among the family members and hence evidence of vertical transmission. In the case of the second patient, we performed PCR and subsequent direct sequ encing of HBV DNA isolated from his HBsAg-positive mother's, as well as fro m his serum, comparing the nucleotide sequences with those of a pregnant wo man diagnosed as an asymptomatic HBV carrier, of another asymptomatic HBV c arrier and of a reference strain, respectively, all belonging to the same g enotype and subtype as the samples tested. Our results clearly indicate the necessity for nation-wide hepatitis B vaccination starting at birth, at le ast in hyperendemic areas like the Far East, in order to forestall HBV carr iage and ensuing cirrhosis and/or HCC by preventing vertical transmission.