Hepatitis B virus transmission and hepatocarcinogenesis: A 9 year retrospective cohort of 13 676 relatives with hepatocellular carcinoma

Chien-Hung CHEN, Yang Yuan CHEN, Gran-Hum CHEN, Sien-Sing YANG, Huang-Shang TANG, Hsien Hong LIN, Deng-Yn LIN, Sing Kai LO, Jeng-Ming DU, Ting-Tsung CHANG, Shinn-Cherng CHEN, Li-Ying LIAO, Chung-Huang KUO, Kwo-Chuan LIN, Dar-In TAI, Chi-Sin CHANGCHIEN, Wen-Yu CHANG, Jin-Chuan SHEU, Ding-Shinn CHEN, Yun-Fan LIAWJuei-Low SUNG

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Background/Aims: Familial clustering of hepatitis B virus (HBV) infection is related to perinatal transmission, and is the main cause of familial-type hepatocellular carcinoma (HCC). The route of HBV transmission differs between the children and siblings of patients with HCC. This study examined the differences in HBV carrier rates and HCC-related mortality between two generations in HCC families.
Methods: From 1992 to 1997, relatives of individuals with HCC were screened prospectively with ultrasonography, alpha-fetoprotein, liver biochemistry tests and viral markers. Total HCC-related deaths during a 9-year period were compared between the generations of index patients and their children.
Results: The study included a total of 13676 relatives in two generations. More HCC-related deaths occurred in the index patient generation than in the child generation. Furthermore, children of female index patients had higher rates of liver cancer related mortality than children of male index patients. The same was true when the analysis was limited to male HBV carriers. The prevalence of HBsAg in the offspring of HBsAg positive mothers was 66% in the child generation and 72% in the index patient generation. These high prevalences indicated high maternal HBV replication status.
Conclusions: Perinatal transmission and maternal viral load are important risk factors in hepatocarcinogenesis. Copyright © 2003 European Association for the Study of the Liver. Published by Elsevier Ireland Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)653-659
JournalJournal of Hepatology
Issue number4
Publication statusPublished - 2004


Hepatitis B virus
Hepatocellular Carcinoma
Hepatitis B Surface Antigens
Child Mortality
Virus Diseases
Liver Neoplasms
Virus Replication
Viral Load
Cluster Analysis


Chen, C.-H., Chen, Y. Y., Chen, G.-H., Yang, S.-S., Tang, H.-S., Lin, H. H., . . . Sung, J.-L. (2004). Hepatitis B virus transmission and hepatocarcinogenesis: A 9 year retrospective cohort of 13 676 relatives with hepatocellular carcinoma. Journal of Hepatology, 40(4), 653-659. doi: 10.1016/j.jhep.2003.12.002


  • Maternal–fetal exchange
  • Taiwan
  • Survival analysis
  • Hepatitis B surface antigen
  • Family