原发性肝癌危险因素的病例—对照研究

目的：研究肝癌（HCC）高发区江苏启东各危险因素的作用大小及相关性,方法：对66对肝癌患者和对照进行1：1配比病例对照研究,采用条件Logistic回归分析来分析以下13个变量的作用,肝炎史,肝硬化,肝癌家族史,既往饮水类型,食用腌制品,饮酒,HBsAg,抗－HBc, 抗－HBe、抗－HBs、HBVDNA和抗－HCV。结果：单因素分析揭示肝炎史,肝硬化、肝癌家族史,既往饮水类型,饮酒,HBsAg,抗－HBc, 抗－HBe、抗－HBst HBV DNA有显著性差异,多因素分析得到三个有统计学意义的模型,结论：在肝癌高发区启东市,乙型肝炎病毒（HBV）感染、既往饮水类型,肝癌家族史和饮酒是肝癌的主要危险因素,丙型肝炎病毒（HCV）感染无统计学意义。     

乙型肝炎病毒感染对健康影响的队列研究

目的:探讨乙型肝炎病毒(HBV)感染对健康的影响。方法:在原发性肝癌(HCC)高发区江苏省海门市建立前瞻性研究队列人群,对研究对象进行流行病学调查,采集外周静脉血检测HBsAg及其他相关指标,每年随访队列成员的生命状况及死因。以HBsAg作为HBV感染指标,比较HBsAg暴露和阴性组人群的死亡密度。并应用COX风险模型探讨HBV感染在原发性肝细胞癌(HCC)发生中的风险率比(HR)。结果:HBsAg暴露组人群的死亡密度为1482.35/10万人年,是对照组的3.42倍。HCC是研究组的首位死因,占全部死亡的52.28%,与对照组相比RR=15.63,AR=93.60%。男性HR=22.3,95%CI 18.7~26.6,女性HR=37.2,95%CI=19.1~72.5。结论:感染HBV对机体健康有明显影响。     

山西省强制戒毒者HBV感染状况及影响因素分析

目的 了解山西省强制戒毒者乙型肝炎病毒（hepatitis B virus,HBV）感染状况,初步探讨强制戒毒者HBV感染的影响因素。方法 于2014年6月～12月对山西省3所强制戒毒所1 176名强制戒毒者进行面对面问卷调查,收集一般人口学特征、HBV感染的可能影响因素等资料;同时采集静脉血5 ml,采用酶联免疫吸附（enzyme linked immunosorbent assay,ELISA）法检测HBsAg和抗-HBs。用非条件Logistic回归模型分析HBV感染的影响因素,并对分析出的危险因素进行交互作用分析。结果 1 176名强制戒毒者年龄范围为18～65岁,年龄均数为（37.91±8.58）岁,其中男性1 118人,女性58人;HBsAg、抗-HBs的阳性率分别为4.68%（55/1 176）、34.69%（408/1 176）。Logistic回归分析显示,乙肝家族史（OR=6.654,95% CI: 2.550～17.364）、修脚史（OR=1.955,95% CI: 1.086～3.518）和丙型肝炎史（OR=7.935,95% CI: 1.496～42.098）是HBV感染的危险因素,血清抗-HBs阳性是HBV感染的保护因素（OR=0.125,95% CI: 0.044～0.359）。修脚史和乙肝家族史之间未发现相加及相乘交互作用（均有P>0.05）。结论 强制戒毒人群是HBV感染的高危人群,乙肝家族史、丙型肝炎史和修脚史是该人群HBV感染的危险因素,对该人群应加强乙肝疫苗接种,并采取针对性的干预措施。     

献血者感染乙型肝炎影响因素的病例对照研究

[目的]研究探讨共用剃刀等危险因素与乙型肝炎传播的关系。[方法]对282名单纯HBsAg检测为阳性的献血者及564名阴性献血者进行病例对照研究,应用多因素条件Logistic回归模型分析与感染丙肝有关的因素,并对危险因素的人群归因危险度（PAR）进行估计。[结果]筛选出8个与感染乙肝有关的因素,使用共用剃刀、手术史、针灸史、10年前注射史、乙肝家族史、纹身、牙科史、穿耳环孔等因素增加感染的危险性,其危险度（OR）分别是：10.1235、2.5892、8.5870、8.4407、3.4377、5.5253、2.3673、3.1369,人群归因危险度分别是：49.22%,13.93%,17.23%,77.21%,16.60%,10.16%,26.21%,20.77%。8项危险因素总的人群归因危险度为96.81%。[结论]共用剃刀以及可能导致血液接触的器具是乙型肝炎传播的危险因素。     

舟山渔民乙型病毒性肝炎感染现状及危险因素研究

目的了解舟山海岛渔民乙型病毒性肝炎的危险因素,为进一步开展渔民乙型病毒性肝炎的防治工作提供科学依据。方法以整群抽样的方法抽取全市6个渔业村（捕捞队）的20—65岁渔民作为研究对象,采用统一编制的调查表进行面对面的问卷调鸯,并检测其HBsAg、抗-HBs和抗-HBc等血清学指标。同时采用X^2检验和Logistic回归分析渔民感染乙肝病毒（HBV）的危险因素。结果研究对象HBV总感染率为61．4％,肝炎史、乙肝家族史、使用内窥镜史、饮生水史及饮黄酒是感染HBV的危险因素,而自用水杯为保护因素。结论应加大对渔民的乙型病毒性肝炎健康教育,改变不正确的认识和不良行为习惯,减少危险因素的发生,增强自我保护意识。     

天津市农村人群2型糖尿病危险因素的病例对照研究

目的探讨天津市农村人群2型糖尿病的危险因素。方法对天津农村人群进行多级分层整群抽样调查,共抽取9961例居民。调查对象中已确诊的糖尿病患者为585例,通过年龄、性别频数配比选取620例非糖尿病调查对象进行社区为基础的病例对照研究。结果糖尿病家族史（OR=2．671）、精神压抑（OR=3．759）、体质指数升高（OR=1．502）、腰臀比升高（OR=1．740）、高血压史（OR=2016）和高血脂史（OR=1．867）可增加2型糖尿病发生的危险,而食用水果（OR=0．736）则减少2型糖尿病发生的危险。结论糖尿病家族史、精神压抑、超重、中心性肥胖、高血压史和高血脂史可能是天津农村2型糖尿病发生的危险因素,多食水果则可能是2型糖尿病发生的保护因素。     

大学新生乙肝病毒表面抗原阳性的危险因素分析

目的探讨某高校入学新生乙肝病毒表面抗原（hepatitis Bvirus surface antigen,HBsAg）阳性的危险因素并分析因素间的交互作用。方法采用分层整群抽样方法抽取该校919名新生进行问卷调查并采集血样,使用酶联免疫吸附法（enzyme—linked immunosorbent assay,ELISA）定性检测HBsAg。采用检验和非条件Logistic回归模型分析HBsAg阳性的危险因素,应用相加效应模型分析各危险因素间的交互作用。结果所调查的919名新生HBsAg阳性率为10．12％（93／919）。多因素分析结果表明HBsAg阳性的危险因素包括：男性、来自农村、未接种乙肝疫苗、有乙型肝炎病毒（hepatitis Bvirus,HBV）家族感染史和穿耳洞,其0R值分别为2．838、1．669、2．824、8．555、2．965。其中HBV家族感染史与性别、乙肝疫苗接种史之间存在交互作用,超额相对危险度（relative exeess risk of interaction,RERI）分别为17．828和55．675。结论男性、来自农村、未接种乙肝疫苗、有HBV家族感染史和穿耳洞是HBsAg阳性的危险因素,其中HBV家族感染史与性别、疫苗接种史之间存在相加交互作用。     

远洋船员乙型肝炎病毒感染的影响因素分析

目的 分析舟山海岛地区远洋船员感染HBV的影响因素,为该地区乙型肝炎的防治提供科学依据.方法 本研究选择2011年7月1日至2012年6月30日在舟山医院进行体检且HBsAg指标阳性的453名远洋船员作为感染组.按照1：1选择以年龄±2岁、同工种且乙型肝炎标志物检测全阴者进行匹配,设立453名对照,并进行影响因素分析.结果 单因素分析结果表明,乙型肝炎疫苗接种是感染HBV的保护因素（OR=0.507,x2=11.339,P＜0.05）,而饮用生水和出国劳务是感染HBV的危险因素（OR=1.471、2.215,P＜0.05）.多因素条件Logistic回归分析显示,乙型肝炎疫苗接种史是海岛船员感染乙型肝炎的保护因素（OR=0.523,x2=10.150,95％CI：0.351～0.779）,出国劳务史是海岛远洋船员感染乙型肝炎的危险因素（OR=1.992,x2=5.000,95％CI：1.089～3.646）.结论 出国劳务史是海岛船员感染乙型肝炎的主要危险因素,乙肝疫苗接种史是HBV感染的保护因素,应强化远洋船员乙型肝炎疫苗接种,并加强远洋船员的安全性健康教育.     

手足口病重症病例危险因素分析

目的探讨手足口病重症病例的危险因素。方法采用病例对照研究方法,病例组为182例手足口病重症病例,对照组为265例手足口病轻症病例,用问卷调查收集病例组和对照组的社会人口学特征、出生及喂养情况、既往史、接触史、就诊史、临床症状、实验室诊断等信息,对重症病例危险因素分析采用单因素和多因素非条件Logistic回归分析。结果单因素分析发现：身高、体重、职业、户口类型、早产儿、就医延迟时间、发热、病毒类型、外周血白细胞计数是重症发生的相关因素。多因素非条件Logistic回归分析发现流动人口（OR=2.182,p=0.021）、早产儿（OR=12.456,p=0.000）、发热（OR=2.234,p=0.009）、EV71（OR=6.575,p=0.000）、外周血白细胞计数升高（OR=2.731,p=0.008）是患手足口病重症的危险因素（p<0.05）。结论开展手足口病的健康教育工作,对手足口病重症的危险因素早期监测,及时对症治疗,达到降低手足口病病死率的目的。     

西安地区体检人群乙型肝炎病毒感染情况及影响因素分析

目的 探讨西安地区体检人群乙型肝炎病毒（HBV）感染情况及影响因素。方法 随机抽取2020年4月至2021年5月于空军军医大学第一附属医院体检的人群进行一对一问卷调查,并进行HBsAg以及抗-HBs检测,统计分析其HBV感染情况,并就HBV感染的影响因素进行分析。结果 共有1 504名数据完整的体检人员纳入分析,其中男923人（61.37%）,女581人（38.63%）,以≥61岁者为主（630,41.89%）;汉族935人（62.17%）,在婚1 251人（83.18%）,文化程度以初高中为主（901,59.91%）。HBsAg检测阳性者128例（8.51%）。多因素Logistic回归分析显示,乙肝家族病史（OR=1.865）、拔牙史（OR=1.432）、侵入性诊疗史（OR=2.333）、无乙肝疫苗接种史（OR=2.130）是HBV感染的独立危险因素。结论 西安地区体检人群HBsAg阳性率较高,应加强关注存在乙肝家族病史、拔牙史、侵入性诊疗史、无乙肝疫苗接种史人员,降低其HBV感染风险。     

江苏省海门市原发性肝癌队列随访结果分析

目的 分析海门原发性肝癌队列（海门队列）中死亡情况及其危险因素。方法 海门队列自1992年建立,共纳入25~69岁健康人群89 789人。对入组研究对象进行基线调查并采集外周静脉血10 ml,检测HBsAg,并对生存状况及肝癌死亡情况每年进行1次随访。计算肝癌死亡率,采用Cox比例风险模型进行多因素分析。结果 截至2014年12月31日,海门队列共随访1 299 611人年,其中2 583（男性2 149,女性434）例死于肝癌。肝癌死亡病例中HBsAg阳性者占73.87%。男女性肝癌死亡率分别为247.80/10万人年和100.38/10万人年。多因素分析显示,HBsAg阳性是海门队列男女性原发性肝癌最为主要的危险因素（男性：HR=15.97,95% CI：14.29~17.85;女性：HR=21.63,95% CI：16.16~28.96）。年龄、吸烟史、既往肝炎史以及肝癌家族史均与原发性肝癌发病风险有关。结论 海门地区成年人原发性肝癌死亡率处于较高水平,HBV感染仍为该地区最主要的危险因素。     

江苏省海门市1993--2006年肝癌死亡率时间趋势分析

目的 预测海门市男性肝癌死亡趋势,并定量描述肝癌死亡率的年龄、时期和出生队列特征.方法 应用男性肝癌1993-2006年的年龄标化死亡率(SMR)构建GM(1,1)模型,预测SMR至2012年.同时,以每4年为一间隔的肝癌死亡密度(MD)拟合年龄-时期-队列(age-period-cohort,APC)模型的梯度模型,并进行模型拟合优度评价和模型比较,筛选最优模型;根据APC全模型和最优模型的拟合结果评估年龄、时期和出生队列效应;利用最优模型预测MD至2012年.结果 根据构建的GM(1,1)残差修正模型对SMR进行预测,结果显示,2007年SMR预测值为48.578/10万,相对误差为-1.267%;2008-2012年男性SMR轻微下降,最低值为45.578/10万(2012年).APC梯度模型拟合优度检验及模型比较结果显示,年龄-时期模型为最优模型(△G2=9.065,AIC=202.544).APC模型的曲率估计结果显示,曲率改变显著的年龄组为36.5～40.5岁(-0.368)和64.5～68.5岁(-0.489),队列作用的曲率改变主要发生在1956-1959年(C2 1949.5,1967.5=-0.492);年龄-时期模型的分层相对危险度估计结果显示,随年龄增加,年龄效应呈升高趋势,至64.5～68.5岁组后开始下降;时期越晚相对危险度越低.年龄-时期模型的预测结果显示2005-2012年肝癌死亡率呈下降趋势.结论 年龄、时期和部分队列效应可以预测肝癌死亡率趋势;未来几年肝癌死亡率会略微下降,但仍处于较高发病状态.     

Chronic hepatitis B virus infection and mortality from non-liver causes: results from the Haimen City cohort study

BACKGROUND: Studies of chronic hepatitis B virus (HBV) infection in endemic populations have rarely documented causes of mortality other than liver disease and hepatocellular carcinoma (HCC). METHODS: We analysed all-cause mortality related to HBV infection, focusing on the deaths not related to liver disease in a prospective cohort of adults living in Haimen City, China, who were followed from 1992 to 2002. Death certificate data from 4590 deaths among 83 794 individuals were analysed. At cohort entry, 15.0% of the 58 454 male subjects and 10.7% of 25 340 female subjects were hepatitis B surface antigen positive [HbsAg(+)]. HCC and chronic liver disease were the major causes of death in both men and women in this population. The analysis focused on non-liver causes of death. RESULTS: When liver-related causes of death were excluded, there was still a significantly higher age-adjusted death rate among HBsAg(+) individuals. The relative risks (RRs) and 95% confidence intervals (CIs) for all non-liver deaths among HBsAg(+) subjects were 1.2 (1.1-1.3) in men and 1.4 (1.1-1.7) in women. Non-liver causes were further subdivided into cancer and non-cancer groups. For all non-liver cancers, the RR was 1.2 (1.0-1.4) for males and 1.7 (1.2-2.3) for females. Non-liver, non-cancer deaths had RRs of 1.2 (1.1-1.4) and 1.2 (0.9-1.6) in males and females, respectively. CONCLUSIONS: HBV-infected individuals may be at increased mortality risk from non-liver causes. Possible reasons include a direct effect of HBV infection, changes in the host immune system as a cause or effect of chronic infection, and behavioural factors associated with HBV infection. Further studies are needed to confirm this finding.     

survivin基因易感性及其单倍型与原发性肝细胞癌关系

目的 探讨汉族人群中存活素(survivin)基因rs8073069及rs1042489位点与原发性肝细胞癌(HCC)的相关性,为采取干预措施提供参考依据。方法采用病例对照研究方法对在江苏省海门市10个社区收集的176例汉族HCC病例和随机匹配的196名健康汉族人群进行一般情况问卷调查以及survivin基因rs8073069和rs1042489位点基因分型。结果 rs8073069位点CC、CG、GG基因型和C、G 2个等位基因在HCC病例组的频率分别为8.52%、35.22%、56.25%2、6.14%7、3.86%,在对照组的频率分别为6.12%3、9.80%、54.08%、26.02%7、3.98%,不同遗传模式下rs8073069位点基因型和等位基因分布在HCC病例组与对照组间分布差异均无统计学意义(P>0.05);rs1042489位点CC、CT、TT基因型和C、T 2个等位基因在HCC病例组的频率分别为17.61%、55.68%、26.70%、45.45%、54.55%,在对照组的频率频率为13.78%、52.04%、34.18%、39.80%、60.20%,不同遗传模式下rs1042489位点基因型及等位基因在HCC病例组与对照组间分布差异均无统计学意义(P>0.05);多因素Logistic回归分析结果表明,在相加遗传模式下,HBsAg+和有乙肝史是HCC的危险因素r,s8073069G-rs1042489T单倍型是HCC的保护因素;不同遗传模式下环境因素与单倍型交互作用分析结果表明,显性、隐性和相加遗传模式均未发现单倍型与环境因素的交互作用(P>0.05)。结论 汉族人群survivin基因rs8073069和rs10424892位点多态性与HCC的易感性无关;rs8073069G-rs1042489T单倍型是HCC的保护单倍型。     

Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection.

Both experimental and epidemiologic studies have linked a low dietary intake of selenium with an increased risk of cancer. The authors examined the association between plasma selenium levels and risk of hepatocellular carcinoma (HCC) among chronic carriers of hepatitis B and/or C virus in a cohort of 7,342 men in Taiwan who were recruited by personal interview and blood draw during 1988-1992. After these men were followed up for an average of 5.3 years, selenium levels in the stored plasma were measured by using hydride atomic absorption spectrometry for 69 incident HCC cases who were positive for hepatitis B surface antigen (HBsAg) and/or antibodies against hepatitis C virus (mostly HBsAg positive) and 139 matched, healthy controls who were HBsAg positive. Mean selenium levels were significantly lower in the HCC cases than in the HBsAg-positive controls (p = 0.01). Adjusted odds ratios of HCC for subjects in increasing quintiles of plasma selenium were 1.00, 0.52, 0.32, 0.19, and 0.62, respectively. The inverse association between plasma selenium levels and HCC was most striking among cigarette smokers and among subjects with low plasma levels of retinol or various carotenoids. There was no clear evidence for an interaction between selenium and alpha-tocopherol in relation to HCC risk.     

原发性肝癌与出生顺序的研究

目的：分析原发性肝癌患者的出生顺序，探讨环境因素与肝癌的关系。方法：根据Greenwood及Haldane的出生顺序方法，对来自江苏省海门市8年随访队列的100个家系中100例先证者及22例患病同胞进行出生顺序研究，结果：Greenwood法分析结果显示，患者出生顺序在1－3胎次的个体较多，当控制了乙型肝炎病毒感染的影响后，结果仍显示肝癌病人好生出生顺序较早的个体。Haldane法计算∑6A实验值＝1806，∑A理论值＝1988，实际6A值与期望6A值相差两个标准差以上，|∑6A实际值－∑6A期望值|／√∑V6A=2.1657，差异有显著的统计学意义（0．02＜P＜0．05），实际6A值比期望6A值小，说明出生顺序越小的个体越容易患肝癌，生态学研究结果显示，海门市普及自来水10年后的肝癌死亡率随时间推移明显下降，经Spearman相关显著性检验，相关系数为－0．818（P＜0．01），提示早期出生的个体中肝癌的发病与当地饮用水的水质有关。结论：肝癌的发生与出生顺序有关，发生在出生较早的个体，这与国外报道的肝癌好发于出生顺序较晚个体的结论不一致。生态学研究表明，长期饮用沟塘水与肝癌好在出生顺序较早的个体有关，提示环境因素对肝癌的发生有一定的影响。     

Mortality of hepatitis B surface antigen-positive blood donors in England and Wales

BACKGROUND: Large population-based cohort studies in areas of high hepatitis B virus (HBV) prevalence have provided the evidence establishing hepatitis B surface antigen (HBsAg) carriage as a risk factor for hepatocellular carcinoma (HCC) and liver disease. Fewer studies have examined this in Western countries, where both HBV infection and carriage are less common and transmission patterns differ. This is the only prospective population-based study to examine this relationship in Europe. METHODS: In all, 2681 male and 977 female blood donors in England and Wales, found to be HBsAg positive during routine blood-donation screening, were followed up from recruitment in 1970-1982 to December 1999 and their cause-specific mortality was analysed. This was compared with that of the general population of England and Wales. RESULTS: During a mean of 22 years of follow-up, 17.4% of the 420 deaths were due to HCC or liver disease. There were 20 deaths from HCC in male HBsAg carriers, representing a significantly high standardized mortality ratio (SMR) compared to the male population of England and Wales of 26 (SMR = 26.26; 95% CI: 16.04- 40.54). The HCC incidence rate in males was 33.5 per 100 000 person years and 4.4 per 100 000 person years in females. Men had 8.5 (SMR = 8.50; 95% CI: 6.25- 11.31) and women had 3.9 times the risk of death from liver disease (SMR = 3.89; 95% CI: 1.26-9.09). The risk of circulatory disease deaths was reduced in both males and females. There was a significant increased risk of non-Hodgkins lymphoma that was not apparent in the first decade of follow-up. The increased risk of HCC and liver disease in men fell with follow-up. CONCLUSION: Hepatitis B surface antigen carriage is a significant risk factor in England and Wales for both liver disease and HCC mortality. However, this risk has declined with duration of follow-up. This could be due to natural reversion to HBsAg negativity or as a result of treatment and avoidance of other risk factors. The increased risk of non-Hodgkins lymphoma seen in longer follow-up is likely to be related to HIV infection acquired subsequent to recruitment.     

广西肝癌高发区人群血清微囊藻毒素-LR水平及影响因素分析

目的了解广西肝癌高发区健康人群血清微囊藻毒素-LR(microcystin-LR,MC-LR)水平及其影响因素。方法于2015年6月,收集广西肝癌高发区健康人群103人、低发区健康人群100人的基本信息及静脉血,采用酶联免疫法检测血清MC-LR水平以及乙肝病毒表面抗原(HBs Ag),分析两组人群血清MC-LR水平及其相关影响因素。结果广西肝癌高发区健康人群血清MC-LR水平(0.088±0.040μg/L)高于低发区(0.028±0.013μg/L),差异有统计学意义(P0.01);无论是肝癌高发区还是低发区,HBs Ag阳性人群与阴性人群血清MC-LR水平差异无统计学意义(P0.05)。多重逐步线性回归分析结果显示,有塘边渗井水或沟塘水饮用史及本地鱼、鸭食用频率较高者血清中MC-LR水平较高。结论塘边渗井水或沟塘水饮用史及本地鱼、鸭食用频率高是广西肝癌高发区健康人群血清MC-LR水平升高的影响因素。     

Hepatitis B carriage explains the excess rate of hepatocellular carcinoma for Maori, Pacific Island and Asian people compared to Europeans in New Zealand.

BACKGROUND: The aim of this research was to determine the hepatitis B surface antigen (HBsAg) carrier prevalence among cases of hepatocellular carcinoma (HCC), and the population attributable risk of HBsAg carriage for HCC, by ethnicity in New Zealand. METHODS: The hospital notes of HCC cases registered with the New Zealand Cancer Registry, for the years 1987-1994 inclusive, were viewed to determine the HBsAg status. Results The HBsAg status was determined for 193 cases of HCC. The HBsAg carrier prevalence for non-Europeans with HCC was markedly higher than that for Europeans, being 76.7% for Maori, 80.0% for Pacific Island people, and 88.5% for Asians, compared to 6.0% for Europeans. In addition to the effect of ethnicity, HCC cases aged <60 years were more likely to be HBsAg carriers than those aged > or = 60 years. The estimated population attributable risk of HBsAg for HCC, within each ethnic group, was only marginally less than the HBsAg prevalence due to the high relative risk of HBsAg carriage for HCC. The standardized incidence rate ratios of HCC for Maori, Pacific Island people and Asians compared to Europeans were 9.6, 20.4, and 22.3, respectively. Hepatocellular carcinoma attributable to HBsAg carriage explained 79%, 83%, and 92% of the excess standardized rate of HCC, compared to Europeans, for Maori, Pacific Island people, and Asians, respectively. Conclusions The HBsAg carrier prevalence in non-European cases of HCC in New Zealand is between 75% and 90%. HBsAg carriage explains the majority of the excess rate of HCC in non-Europeans compared to Europeans in New Zealand.     

Increased risk for hepatitis B-related liver cirrhosis in relatives of patients with hepatocellular carcinoma in northern Taiwan

BACKGROUND: There is a tendency for familial aggregation of hepatocellular carcinoma (HCC). The aims of this study were to assess the degree to which familial aggregation of hepatitis B surface antigen (HBsAg) carriers accounts for familiality of HCC in families of hepatitis B-related HCC patients, and whether HCC shares a familial predisposition with liver cirrhosis among HBsAg carriers. METHODS: A total of 671 first-degree relatives of HBsAg-positive HCC cases were recruited using abdominal ultrasonography and tests for HBsAg and serum aminotransferases. They were from 165 simplex families defined as having only one HCC case and 72 multiplex families with more than one case. In analyses of family history of HCC and cirrhosis, the data set consisted of 4,471 unrelated asymptomatic HBsAg carriers recruited in a prospective study. RESULTS: There was no significant difference in the HBsAg-positive rate among relatives between multiplex (55.7%) and simplex (48.1%) families. Sonographic evidence of liver cirrhosis was present in 14.4% of HBsAg-positive relatives from multiplex families but in only 7.8% of HBsAg-positive relatives from simplex families (multiplex versus simplex families: adjusted odds ratio [OR] = 2.29; 95% CI: 1.10-4.77). Among unrelated asymptomatic HBsAg carriers, the adjusted OR of liver cirrhosis associated with a first-degree family history of HCC was 2.80 (95% CI: 1.68-4.66). This association was stronger in HBsAg carriers <50 years. No association was seen between family history of HCC and hepatitis activity based on elevated levels of aminotransferases. CONCLUSIONS: Familial aggregation of HCC in HBsAg carriers is associated with familial clustering of liver cirrhosis.