Hepatitis B Infections Impact ‘Other’ Cancers Too

A new study reported that a Hepatitis B virus (HBV) infection was associated with the risk of non-liver cancer, especially digestive system cancers. 

This is important news since HBV infections affect more than 2 billion people worldwide. 

This cohort study of 496,732 Chinese individuals was published in JAMA on June 14, 2019, concluded that hepatitis B surface antigen (HBsAg) seropositivity was associated with the risk of hepatocellular carcinoma, stomach cancer, colorectal cancer, oral cancer, pancreatic cancer, and lymphoma. 

Additionally, the association between HBsAg seropositivity and stomach cancer was further replicated in 2 other small Chinese studies, in which more sensitive assays for HBsAg detection were used. 

These tissue-based experiments validated the occurrence of HBV expression in cancer cells located in the stomach and pancreas, but not in lung cancer cells. 

"This study provides compelling evidence for the association between HBV infection and all types of cancer," the authors wrote, suggesting a potential role of HBV in the oncogenesis of non-liver cancers.  

“This study presents striking new evidence for the increased risk of non-liver cancers in people with chronic HBV. Although we have a safe and effective treatment to prevent the spread of HBV, the vaccines still remain on the shelf,” said Ravi Prasad, Pharm D Candidate, an intern for Brookshire Grocery Company.   

“The results of this study indicate that we have the tools to prevent horrendous diseases like stomach cancer, oral cancer, colorectal cancer, pancreatic cancer, and lymphoma. Preventing and testing for HBV is indispensable and should be a priority among health care providers around the world.”

Hepatitis B virus has been implicated in the cause of up to 80 percent of hepatocellular carcinoma (HCC) cases, which frequently occurs in Chinese and African populations. 

The virus optimizes its life cycle to allow for long-term persistence in liver tissue by establishing a plasmid-like covalently closed circular DNA  form. 

Chronic HBV infection persisting in liver tissue is associated with increased chronic oxidative damage in hepatocytes, immune-mediated inflammation of the liver, and development of cancer, says the Centers for Disease Control and Prevention (CDC). 

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Hepatitis B is transmitted when blood, semen, or other body fluids from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth.

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For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection.

The risk for chronic infection is related to age at infection: approximately 90 percent of infected infants become chronically infected, compared with 2–6 percent of adults, says the CDC.