Hepatitis B virus (HBV) infection is reported as a major health problem in Africa, Western Pacific and Asian countries especially in sub-Saharan Africa with population 65 million patients that has chronic HBV. The HBV infection is interplay between virus replication and host immune system. By transmitting through the skin or mucous membrane, HBV will cause chronic infection and affect the liver cancer and followed with hepatocellular carcinoma (HCC). Basically, HBV infection are described by four levels of phase that is immune tolerant phase, immune reactive phase, resolution phase and reactivation phase.
Hepatocellular carcinoma is one of the diseases that closely related to the infections with hepatitis B virus (HBV). The institution of Taiwan’s program of universal Hepatitis B vaccination reported that children have stronger association towards HBV and hepatocellular carcinoma compared to adult. After 10 years of launching the vaccination program, the data reported that the incidence of hepatocellular carcinoma is declined from 0.52 to 0.13 referring to the children between 6 to 9 years. In addition, early detection of hepatocellular carcinoma can be enhancing by screening the HBV with ultrasonography and alfa-fat protein. The decrease in HBsAg-seropositive automatically reduced the rate of horizontal HBV infection and reflects the decline in hepatocellular carcinoma.
Based on the case-control and cohort studies show that the presence of HBsAg in serum causes the chronic HBV infection and elevated for HCC development. This kind of problem cause the hepatitis B patients have no hepatitis B surface antigen that detected in serum. After the disappearance of HBsAg and appearance of anti-HBs, the level of HBV DNA in serum and fragments of HBV DNA in occult HBV infections is low. HBV on the other hand also implicated in HCC patients that do not have the evidence of infection with HBV. Patrick et. al reported that HBsAg in some patients is absent but the antibody of HBV core antigen as IgM anti HBc are detected.
By using the immunodetection technique, about 12-21% of HBsAg was detected in nontumour tissue from the patients from low HCC incidence country with the HBsAg in the nontumour tissue but the percentage of detection in the tumour tissue is less frequently. The HBs core antigen on the other hand, also detected with high frequently in the nontumorous liver tissue. Other observation shows that HCC that grow in the tissue culture that contain integrated HBV DNA was provides the presence of HBV in malignant hepatocyte and integrate into the chromosomal DNA.
The recent study reported that the patient with the F genotype that population from South and Central America has 68% of having HCC compared 18% without HCC. Other than that, people with genotype B and C in Eastern and South-Eastern Asia have faster HCC development compared to the genotype C in Taiwanese. These results show that the viral genotype ...