Hepatitis B virus reactivation in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization therapy
- 15 May 2012
- journal article
- Published by Wiley in Asia-Pacific Journal of Clinical Oncology
- Vol. 8 (4), 356-361
- https://doi.org/10.1111/j.1743-7563.2012.01534.x
Abstract
The effect of transcatheter arterial chemoembolization (TACE) therapy on hepatitis B virus (HBV) reactivation in hepatocellular carcinoma (HCC) patients with prior resolved hepatitis B is not fully understood. From January 2006 to December 2010, 43 hepatitis B surface antigen (HBsAg)-negative/anti-hepatitis B core antigen (HBc) positive patients with newly diagnosed unresectable HCC were enrolled in the study. All underwent TACE therapy. Four patients (9.3%) developed HBV reactivation with mild/moderate hepatitis. The median number of TACE cycles received was 3.5 (range 3-4 cycles). The median time interval between the occurrence of HBV reactivation and the completion of TACE therapy was 3 months (range 1-5 months) and their median HBV DNA level was 1.58 × 10(4) IU/mL (range, 1.65 × 10(3) -6.42 × 10(4) IU/mL). After the introduction of lamivudine at the occurrence of HBV reactivation, all had resolution of hepatitis. An exploratory analysis indicated that significant predictors of HBV reactivation included increased serum total bilirubin coexisting with cirrhosis and the total number of cycles of TACE received. The administration of TACE therapy may increase the risk of HBV reactivation in HBsAg-negative/anti-HBc-positive patients diagnosed with unresectable HCC. Further studies are warranted to explore the optimal management of HBV reactivation in patients with prior resolved hepatitis B.Keywords
This publication has 11 references indexed in Scilit:
- Risk of HBV Reactivation According to Viral Status and Treatment Intensity in Patients with Hepatocellular CarcinomaAntiviral Therapy, 2011
- Hepatitis B Virus Reactivation in Lymphoma Patients With Prior Resolved Hepatitis B Undergoing Anticancer Therapy With or Without RituximabJournal of Clinical Oncology, 2009
- A revisit of prophylactic lamivudine for chemotherapy-associated hepatitis B reactivation in non-Hodgkin's lymphoma: A randomized trialHepatology, 2007
- Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapyHepatology, 2006
- A randomized controlled study of preemptive lamivudine in patients receiving transarterial chemo-lipiodolizationHepatology, 2006
- Risk of Hepatitis B Exacerbation is Low After Transcatheter Arterial Chemoembolization Therapy for Patients with HBV-related Hepatocellular Carcinoma: Report of a Prospective StudyThe American Journal of Gastroenterology, 2005
- Transarterial chemo-lipiodolization can reactivate hepatitis B virus replication in patients with hepatocellular carcinomaJournal of Hepatology, 2004
- Long-term histologic and virologic outcomes of acute self-limited hepatitis BHepatology, 2003
- Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trialThe Lancet, 2002
- The hepatitis B virus persists for decades after patients' recovery from acute viral hepatitis despite active maintenance of a cytotoxic T–lymphocyte responseNature Medicine, 1996