Association of pre-S deletion mutant of hepatitis B virus with risk of hepatocellular carcinoma

Background: Pre‐S deletion mutant of hepatitis B virus (HBV) affects the expression of middle and small surface proteins, resulting in intracellular accumulation of large surface protein. The correlation between pre‐S deletion mutant and risk of hepatocellular carcinoma (HCC) in hepatitis B virus carriers remains unclear. Methods: Using molecular assays, pre‐S deletion mutant of HBV were determined in 266 patients with chronic HBV genotype B or C infection. They included 202 asymptomatic carriers and 64 HCC patients. Results: The overall prevalence of pre‐S deletion mutant was 16.5%. Hepatocellular carcinoma (odds ratio [OR], 3.23; 95% confidence interval [CI], 1.23–8.48, P = 0.02) and genotype C (OR, 3.19; 95%CI, 1.54–6.62, P = 0.002) were independently associated with the presence of pre‐S deletion mutant. The prevalence of pre‐S deletion mutant was comparable between HCC patients with genotype B and C infection. Nevertheless, in asymptomatic carriers, patients with genotype C infection were significantly associated with the presence of pre‐S deletion mutant compared to those with genotype B infection (20.8% vs 7.2%, P = 0.007). Compared with age‐ and genotype B‐matched asymptomatic carriers, young HCC patients (