Onco Targets Ther. 2016 Jul 25;9:4593-603. doi: 10.2147/OTT.S104300. eCollection 2016.
Postoperative hepatitis B virus reactivation in hepatitis B virus-related hepatocellular carcinoma patients with hepatitis B virus DNA levels <500 copies/mL.Xie ZB1, Wang XB2, Fu DL3, Zhong JH4, Yang XW5, Li LQ4. Author information
1Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai.
2Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Department of Hepatobiliary Surgery, Affiliated Minzu Hospital of Guangxi Medical University.
3Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai.
4Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, People's Republic of China.
5Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
AbstractBACKGROUND: Patients with hepatocellular carcinoma have the risk of postoperative hepatitis B virus (HBV) reactivation (PHR). Antiviral therapy was given to patients with detectable HBV DNA levels but not to patients with undetectable HBV DNA levels.
METHODS: In this retrospective study, 258 patients were enrolled (HBV DNA levels <500 copies/mL group, n=159, and HBV DNA levels >500 copies/mL group, n=99).
RESULTS: A total of 50 patients (19.4%) had PHR. The following significant factors related to PHR were found: without antiviral therapy (hazard ratio [HR] =0.17, 95% confidence interval [CI] 0.031-0.911), hepatitis B e antigen positivity (HR =5.20, 95% CI 1.931-14.007), hepatitis B core antigen S1 positivity (HR =2.54, 95% CI 1.116-5.762), preoperative HBV DNA levels ≥500 copies/mL (HR =1.28, 95% CI 1.085-2.884), hepatic inflow occlusion (HR =3.60, 95% CI 1.402-9.277), moderate liver cirrhosis or more (HR =2.26, 95% CI 1.001-5.121), and blood transfusion (HR =2.89, 95% CI 0.836-10.041). Recurrence-free survival time was significantly shorter in patients with PHR (23.06±2.46 months) than in patients without PHR (29.30±1.27 months).
CONCLUSION: Antiviral therapy could efficiently decrease the incidence of PHR. Patients with HBV DNA levels <500 copies/mL still have the risk of PHR. PHR remained as a prognostic risk factor for hepatocellular carcinoma recurrence and recurrence-free survival.
KEYWORDS: HBV DNA levels; hepatectomy; hepatitis B virus; hepatocellular carcinoma; postoperative reactivation