Yang Y, et al. - Researchers aimed to investigate the individual and combined effects of hepatitis B surface antigen (HBsAg) level and viral load on liver cancer risk. In this study, elevated levels of hepatitis B virus (HBV) DNA and HBsAg were correlated with increased risks of liver cancer. Chronic HBsAg carriers could be suggested to simultaneously lower the viral load to < 2,000 IU/ml and HBsAg level to < 100 IU/ml to lower their liver cancer risk.

• The researchers performed a nested case-control study including 211 liver cancer cases and 221 controls who were sero-positive for HBsAg within 2 population-based cohorts in Shanghai.
• They conducted logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs).

• In dose-response manners, risk of liver cancer was positively associated with increasing levels of HBV DNA and HBsAg.
• The adjusted ORs increased from 2.11 (95%CI: 0.99-4.50) to 10.47 (95%CI: 5.06-21.68) for those with HBV DNA level at 2,000-19,999 IU/ml to ≥ 20,000 IU/ml compared to subjects with HBV DNA < 2,000IU/ml.
• The adjusted ORs increased from 1.82 (95%CI: 0.90-3.68) to 2.21 (95%CI: 1.10-4.43) for those with HBsAg level at 100-999 IU/ml to ≥ 1,000 IU/ml compared to subjects at a low level of HBsAg (0.05-99 IU/ml).
• In comparison with subjects having HBV DNA < 2,000 IU/ml and HbsAg < 100IU/ml, the adjusted ORs were increased from 2.20 (95%CI: 1.07-4.49) for those with HBV DNA < 2,000IU/ml and HbsAg ≥ 100IU/ml to 6.94 (95%CI: 3.39-14.23) for those with HBVDNA ≥ 2,000IU/ml and HBsAg<1,000IU/ml, and 16.15 (95%CI: 7.60-34.32) for those with HBVDNA ≥ 2,000IU/ml and HbsAg ≥ 1,000IU/ml.