A Mutation in the Hepatitis B Virus Predicts Liver Cancer Development

Alvaro Munoz, Ph.D., Thomas Kensler, Ph.D., and John Groopman, Ph.D.
The Johns Hopkins University Bloomberg School of Public Health
P01ES06052 and P30ES03819

Background: Liver cancer is the fifth most prevalent form of cancer worldwide causing over 427,000 deaths in 1990. Exposure to the hepatitis B virus is a major risk factor for the development of liver cancer. Previous work by this investigator has shown that hepatitis B exposure causes a 7-fold risk. Exposure to aflatoxin, a mold commonly found in peanuts and grains, increases the risk of liver cancer by 3.5 times. These two agents combined cause a remarkable 60-fold increase in risk of liver cancer. This is an especially troubling public health problem in China where hepatitis B and aflatoxic exposure are both very high.

Advance: The current study by this NIEHS-supported investigator examines a particular mutation in the hepatitis B virus. Studies were conducted of the prevalence of the mutation in plasma and tumors of from patients living in Qidong, People's Republic of China. Initial studies determined that about three-fourths of the tumors from the patients contained the mutation. The investigators went on to determine that plasma samples contained the virus mutation about half the time before cancer had appeared.

Implication: These findings suggest that detection of the mutated hepatitis B virus is an early warning sign of subsequent liver cancer development. Early detection, even before liver cancer can be detected, is very important in prevention and intervention trials and may lead to better treatment outcomes.

Citation: Kuang SY, Jackson PE, Wang JB, Lu PX, Munoz A, Qian GS, Kensler TW, and Groopman JD. Specific mutations of hepatitis B virus in plasma predict liver cancer development. Proc Nat Acad Sci USA. 2004 Mar 9; 101(10):3575-80.