Replication of hepatitis B virus in first-decree relatives of patients with hepatocellular carcinoma

Hepatocellular carcinoma (HCC) may occur in family clusters. No genetic mec hanism has been identified as responsible for this familial tendency. We su spected that a longer hepatitis B virus (HBV) replication phase might be th e reason for a higher risk of HCC in families with this disease. We perform ed liver biochemical tests, test for viral hepatitis markers and hepatitis B e antigen (HBeAg), and liver ultrasonography in relatives of patients wit h HCC. A total of 1,885 first-degree relatives from 688 families participat ed in this study. Seven hundred fifty-two relatives were found to be carrie rs of hepatitis B surface antigen (HBsAg) and 675 of them were tested for H BeAg. The prevalence of HBeAg was 27.4% in relatives of those with HCC and 20% in asymptomatic HBsAg carriers. The HBeAg prevalence rate was higher in relatives of those with HCC greater than or equal to 40 years old than in asymptomatic HBsAg carriers. Moreover, HBeAg was more likely to persist in men than in women greater than or equal to 40 years old. We conclude that f amilies with HCC showed a prolonged HBV replication phase that may be one o f the cofactors for a familial tendency for HCC.