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According to a study published in The New England Journal of Medicine, the presence of hepatitis B e antigen (HBeAg) appears to predict for a significantly increased risk of developing hepatocellular carcinoma.

Primary liver cancer, the most common type referred to as hepatocellular carcinoma, is characterized by cancer that starts in cells of the liver and can spread, through blood and lymph vessels, to different parts of the body. The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins and fats, the production of bile, the processing of hemoglobin and the detoxification of numerous substances.

Infection with the hepatitis B virus has been shown to increase the risk of the development of hepatocellular carcinoma. However, a proportion of patients with hepatitis B do not develop hepatocellular carcinoma and researchers have been evaluating different variables that may indicate which patients are at a higher risk. The HBeAg is an antigen, or small protein and/or carbohydrate, and when is present in the blood indicates active replication of the hepatitis B virus within cells of the liver. The Hepatitis B surface antigen (HBsAg) is also an antigen of the hepatitis B virus. Researchers believed that these two antigens may be used as markers for patients with hepatitis B virus in determining the risk of hepatocellular carcinoma.

Researchers from the Taiwan Community-Based Cancer Screening Project Group recently conducted a study to evaluate the relationship between the presence of HBsAg, HBsAg plus HBeAg, or neither, and the rate of hepatocellular carcinoma in patients with hepatitis B. The study involved over 11,000 men from Taiwan who were tested for the presence of these antigens and then followed for approximately 9 years. Of these men, 111 developed hepatocellular carcinoma during the time of the study. Men positive for the HBsAg antigen were 9.6 times more likely to develop hepatocellular carcinoma than men who tested negative for both antigen. Men testing positive for both HBsAg plus HBeAg were over 60 times more likely to develop hepatocellular carcinoma than men negative for both antigens.

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These researchers concluded that patients with hepatitis B virus should be tested for HBeAg and if positive, may be candidates for anti-viral treatment and close monitoring in order to prevent, delay or detect hepatocellular carcinoma early. Patients with hepatitis B may wish to speak with their physician regarding the risks and benefits of participation in a clinical trial further evaluating the association between HBeAg and hepatocellular carcinoma or other promising screening and/or treatment strategies. Sources of information regarding ongoing clinical trials include the National Cancer Institute (

Reference: Yang H-I, Lu S-N, Liaw Y-F, et al. Hepatitis B e antigen and the risk of hepatocellular carcinoma.

The New England Journal of Medicine. 2002;347: 168-174.