Elsevier

Journal of Clinical Virology

Volume 64, March 2015, Pages 64-71
Journal of Clinical Virology

Clinical implications of hepatitis B viral infection in Epstein–Barr virus-associated nasopharyngeal carcinoma

https://doi.org/10.1016/j.jcv.2014.11.024Get rights and content

Highlights

Abstract

Background

Little is known about the clinical implication of hepatitis B virus (HBV) infection in Epstein–Barr virus (EBV)-associated nasopharyngeal carcinoma (NPC).

Objective

This study aimed to investigate the clinical characteristics and prognostic factors in patients with newly-diagnosed NPC with HBV infection.

Study design

A total of 722 patients with pathologically-diagnosed NPC who received comprehensive treatment at First People's Hospital of Foshan between June 2006 and December 2011 were enrolled in this retrospective study; 79 and 643 patients were HBsAg(+) and HBsAg(−), respectively. The correlations between HBV (HBsAg status and HBV DNA load) and EBV DNA were analyzed, further long-term survival and prognostic factors also were explored.

Results

We reported NPC patients with HBsAg(+) represented worse outcome, and distant-failure especially liver metastasis was more common in these patients. HBV infection was more frequent in younger patients and male patients. No correlation was observed between the pre-treatment plasma EBV DNA load (cutoff, 1500 copies/ml) and HBsAg status (positive or negative; r = −0.036, P = 0.392), or the pre-treatment plasma EBV DNA load and HBV DNA load (r = 0.042, P = 0823).

Conclusions

Both HBV and EBV infection is an independent negative prognostic factor for long-term survival, distant metastasis, especially liver metastasis, was more common in NPC patients with HBsAg(+), and it seemed no link between EBV DNA load and HBsAg status in NPC.

Section snippets

Background

Oncoviruses contribute to the development of approximately 12% of human cancers and are considered to be an important factor in the activation of malignant cancer, including herpes virus with Kaposi's sarcoma, human papillomavirus with cervical cancer and head and neck cancer, hepatitis B virus (HBV) and hepatitis C virus (HCV) with hepatocellular carcinoma (HCC), human T cell lymphotropic virus-1 with adult T-cell leukemia, and Epstein–Barr virus (EBV) with lymphoma and nasopharyngeal

Objective

We plan to investigate the clinical characteristics and prognostic factors in patients with newly-diagnosed NPC with HBV infection.

Study population

In total, 722 patients with newly pathologically-diagnosed NPC at the First People's Hospital of Foshan between June 2006 and December 2011 were enrolled in this retrospective study. The pre-treatment work-up has previously been described in detail [20], [21]. All patients were routinely screened for hepatitis B at the time of diagnosis using the serologic markers HBsAg, hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe) and hepatitis B

Follow-up, clinical characteristics and virus status

Follow-up protocol was as previously described [20], [21]. The median follow-up time was 51.8 months (range, 1.7–136.5 months). In total, 79 (10.9%) and 643 (89.1%) patients were HBsAg(+) and HBsAg(−), respectively. Histologically, biopsies confirmed that 716 (99.2%) patients had non-keratinizing squamous cell carcinoma. Pre-treatment and post-treatment plasma EBV DNA data was available for 554 (76.7%) and 360 (49.9%) patients, respectively. In the HBsAg(+) cohort (n = 79), pre-treatment HBV DNA

Discussion

Our findings confirm that HBV infection increases the risk for distant recurrence, especially in the liver, and poor survival in patients with EBV-associated NPC. There is no evidence to support an association between HBV status and EBV status in patients with EBV-associated NPC.

Approximately 10–12% of the general population in the endemic area has chronic HBV infection, as indicated by HBsAg seropositivity. The prevalence of HBsAg seropositivity in patients with NPC in this study was 10.9%

Funding

This work was supported by a grant from National Natural Science Foundation of China (81372410, 81071837, 30670627 to YHL), the Natural Science Foundation of Guangdong Province, PR China, (9151008901000223 to HWH) and grants from the National Cancer Institute (R01-CA90853 to FXC), the Sister Institution Network Fund (FXC).

Competing interests

The authors have no commercial or other associations that might pose a conflict of interest.

Ethical approval

The ethical committee of the First People's Hospital of Foshan, Foshan, PR China, approved the study protocol.

Acknowledgements

We thank Ms. Lina Wei and Dr. Jinhuan Cui for support.

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