Polymerase chain reaction to detect hepatitis B virus DNA and RNA sequences in primary liver cancers from patients negative for hepatitis B surface antigen

N Engl J Med. 1990 Jul 12;323(2):80-5. doi: 10.1056/NEJM199007123230202.


Background and methods: The role of hepatitis B virus (HBV) in the course of patients with primary liver cancer who are negative for hepatitis B surface antigen has been debated. We used the polymerase chain reaction to evaluate 28 such patients for the presence of DNA and RNA sequences of the virus; 22 of these patients had associated cirrhosis. The patients were from areas with different prevalences of HBV infection (South Africa, Italy, France, and Japan).

Results: Antibodies to the surface and core antigens of HBV were detected in 10 of the 23 patients tested. HBV DNA sequences were detected in 17 of the 28 patients, including 8 of the 10 with HBV antibodies and 6 of 13 without HBV serologic markers. HBV RNA molecules were found in four of five tumors tested.

Conclusions: Our investigation indicates that transcriptionally active HBV genomes are present in various geographic areas among patients with liver cancer who are negative for hepatitis B surface antigen. This observation is consistent with an etiologic role for the virus in the development of these tumors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Base Sequence
  • DNA, Viral / analysis*
  • Female
  • France / epidemiology
  • Hepatitis B Antibodies / analysis
  • Hepatitis B Core Antigens / immunology
  • Hepatitis B Surface Antigens / analysis*
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B virus / genetics*
  • Humans
  • Italy / epidemiology
  • Japan / epidemiology
  • Liver Cirrhosis / complications
  • Liver Neoplasms / analysis
  • Liver Neoplasms / microbiology*
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Polymerase Chain Reaction
  • RNA, Viral / analysis*
  • South Africa / epidemiology


  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Hepatitis B Surface Antigens
  • RNA, Viral