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Hepatitis B Hepatocellular Carcinoma and Cirrhosis in the Family

The tendency for familial aggregation of hepatocellular carcinoma in hepatitis B surface antigen carriers (HbsAg carriers) is associated with familial clustering of liver cirrhosis.

Dr. M.W. Yu and colleagues studied 671 first-degree relatives of HbsAg-positive people with hepatocellular carcinoma. In total, 165 families were defined as having one case of hepatocellular carcinoma (the simplex families), and 72 families had more than one case (multiplex families). In the analyses of family history of hepatocellular carcinoma and cirrhosis, the data set consisted of 4471 unrelated asymptomatic HbsAg carriers recruited in a prospective study.

The investigators found that there was no significant difference between multiplex and simplex families in the HbsAG-positive rate among relatives (55.7 percent versus 48.1 percent respectively). However, the ultrasonographic evidence of liver cirrhosis in the HbsAg-positive relatives from multiplex families was about double that of the HbsAg-positive relatives from simplex families (14.4 percent versus 7.8 percent; adjusted odds ratio=2.29).

Among unrelated asymptomatic HbsAg carriers, the adjusted odds ratio of liver cirrhosis associated with a first-degree family history of hepatocellular carcinoma was 2.8. This association was found to be stronger in HbsAg carriers under 50 years of age.

Dr Yu concluded, "Familial aggregation of hepatocellular carcinoma in HbsAg carriers is associated with familial clustering of liver cirrhosis."
Int J Epidemiol 2002; 31(5):1008-1015. "Increased risk for hepatitis B-related liver cirrhosis in relatives of patients with hepatocellular carcinoma in northern Taiwan."

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