Observation of hepatitis B reactivation within 1 month after partial hepatectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Junhua , JIA Chenyang , WEI Yonggang , LIU Fei ,  LI Bo

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

LI Bo, Email: cdlibo2015@163.com

Keywords：

hepatitis B virus; hepatocellular carcinoma; hepatectomy; hepatitis B reactivation

DOI：

10.7507/1007-9424.201612078

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To clarify incidence and risk factors of hepatitis B reactivation during short term (one month) in hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) patients receiving partial hepatectomy. Methods From January 2015 to December 2015, 214 consecutive patients with HBV-related HCC who underwent partial hepatectomy were retrospectively enrolled in this study. The risk factors affecting incidence of hepatitis B reactivation were analyzed. Results Hepatitis B reactivation happened in 7.0% (15/214) of patients within 1 month after partial hepatectomy. By univariate analysis, the preoperative HBV-DNA negativity and hepatitis B e antigen (HBeAg) positivity were significantly correlated with the occurrence of hepatitis B reactivation (P=0.023 and P=0.001, respectively). By multivariate analysis, the preoperative HBV-DNA negativity 〔OR=9.21, 95% CI (2.40, 35.45), P=0.001〕 and HBeAg positivity 〔OR=20.51, 95% CI (5.41, 77.73), P<0.001〕 were the independent risk factors for hepatitis B reactivation. Conclusions Hepatitis B reactivation is common after partial hepatectomy for HBV-related HCC during short term, especially in patients whose preoperative HBV-DNA negativity and HBeAg positivity. A close monitoring of HBV-DNA during short term after partial hepatectomy is necessary, once hepatitis B is reactivated, antiviral therapy should be given.

Citation： CHEN Junhua, JIA Chenyang, WEI Yonggang, LIU Fei, LI Bo. Observation of hepatitis B reactivation within 1 month after partial hepatectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(7): 825-829. doi: 10.7507/1007-9424.201612078 Copy

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10.	Jang JW, Choi JY, Bae SH, et al. Transarterial chemo-lipiodolization can reactivate hepatitis B virus replication in patients with hepatocellular carcinoma. J Hepatol, 2004, 41(3): 427-435.
11.	Kim JH, Park JW, Kim TH, et al. Hepatitis B virus reactivation after three-dimensional conformal radiotherapy in patients with hepatitis B virus-related hepatocellular carcinoma. Int J Radiat Oncol Biol Phys, 2007, 69(3): 813-819.
12.	Jang JW, Kwon JH, You CR, et al. Risk of HBV reactivation according to viral status and treatment intensity in patients with hepatocellular carcinoma. Antivir Ther, 2011, 16(7): 969-977.
13.	Lee JI, Kim JK, Chang HY, et al. Impact of postoperative hepatitis B virus reactivation in hepatocellular carcinoma patients who formerly had naturally suppressed virus. J Gastroenterol Hepatol, 2014, 29(5): 1019-1027.
14.	Sohn W, Paik YH, Cho JY, et al. Influence of hepatitis B virus reactivation on the recurrence of HBV-related hepatocellular carcinoma after curative resection in patients with low viral load. J Viral Hepat, 2015, 22(6): 539-550.
15.	Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol, 1982, 5(6): 649-655.
16.	Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
17.	Shaheen AA, Myers RP. Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C-related fibrosis: a systematic review. Hepatology, 2007, 46(3): 912-921.
18.	Edmondson HA, Steiner PE. Primary carcinoma of the liver: a study of 100 cases among 48 900 necropsies. Cancer, 1954, 7(3): 462-503.
19.	Li N, Lai EC, Shi J, et al. A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection. Ann Surg Oncol, 2010, 17(1): 179-185.
20.	Piao CY, Fujioka S, Iwasaki Y, et al. Lamivudine treatment in patients with HBV-related hepatocellular carcinoma—using an untreated, matched control cohort. Acta Med Okayama, 2005, 59(5): 217-224.
21.	Yeo W, Chan PK, Zhong S, et al. Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemo-therapy: a prospective study of 626 patients with identification of risk factors. J Med Virol, 2000, 62(3): 299-307.
22.	Yeo W, Lam KC, Zee B, et al. Hepatitis B reactivation in patients with hepatocellular carcinoma undergoing systemic chemotherapy. Ann Oncol, 2004, 15(11): 1661-1666.
23.	Lim LL, Wai CT, Lee YM, et al. Prophylactic lamivudine prevents hepatitis B reactivation in chemotherapy patients. Aliment Pharmacol Ther, 2002, 16(11): 1939-1944.
24.	Kubo S, Nishiguchi S, Hamba H, et al. Reactivation of viral replication after liver resection in patients infected with hepatitis B virus. Ann Surg, 2001, 233(1): 139-145.
25.	Huang G, Lai EC, Lau WY, et al. Posthepatectomy HBV reactivation in hepatitis B-related hepatocellular carcinoma influences postoperative survival in patients with preoperative low HBV-DNA levels. Ann Surg, 2013, 257(3): 490-505.

1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Goldstein ST, Zhou F, Hadler SC, et al. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol, 2005, 34(6): 1329-1339.
4. Wang FS, Fan JG, Zhang Z, et al. The global burden of liver disease: the major impact of China. Hepatology, 2014, 60(6): 2099-2108.
5. 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2015 更新版). 中华肝脏病杂志, 2015, 23(12): 888-905.
6. Sohn W, Paik YH, Kim JM, et al. HBV DNA and HBsAg levels as risk predictors of early and late recurrence after curative resection of HBV-related hepatocellular carcinoma. Ann Surg Oncol, 2014, 21(7): 2429-2435.
7. Qu LS, Jin F, Huang XW, et al. High hepatitis B viral load predicts recurrence of small hepatocellular carcinoma after curative resection. J Gastrointest Surg, 2010, 14(7): 1111-1120.
8. Sun P, Dong X, Cheng X, et al. Nucleot(s)ide analogues for hepatitis B virus-related hepatocellular carcinoma after curative treatment: a systematic review and meta-analysis. PLoS One, 2014, 9(7): e102761.
9. Yin J, Li N, Han Y, et al. Effect of antiviral treatment with nucleotide/nucleoside analogs on postoperative prognosis of hepatitis B virus-related hepatocellular carcinoma: a two-stage longitudinal clinical study. J Clin Oncol, 2013, 31(29): 3647-3655.
10. Jang JW, Choi JY, Bae SH, et al. Transarterial chemo-lipiodolization can reactivate hepatitis B virus replication in patients with hepatocellular carcinoma. J Hepatol, 2004, 41(3): 427-435.
11. Kim JH, Park JW, Kim TH, et al. Hepatitis B virus reactivation after three-dimensional conformal radiotherapy in patients with hepatitis B virus-related hepatocellular carcinoma. Int J Radiat Oncol Biol Phys, 2007, 69(3): 813-819.
12. Jang JW, Kwon JH, You CR, et al. Risk of HBV reactivation according to viral status and treatment intensity in patients with hepatocellular carcinoma. Antivir Ther, 2011, 16(7): 969-977.
13. Lee JI, Kim JK, Chang HY, et al. Impact of postoperative hepatitis B virus reactivation in hepatocellular carcinoma patients who formerly had naturally suppressed virus. J Gastroenterol Hepatol, 2014, 29(5): 1019-1027.
14. Sohn W, Paik YH, Cho JY, et al. Influence of hepatitis B virus reactivation on the recurrence of HBV-related hepatocellular carcinoma after curative resection in patients with low viral load. J Viral Hepat, 2015, 22(6): 539-550.
15. Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol, 1982, 5(6): 649-655.
16. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
17. Shaheen AA, Myers RP. Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C-related fibrosis: a systematic review. Hepatology, 2007, 46(3): 912-921.
18. Edmondson HA, Steiner PE. Primary carcinoma of the liver: a study of 100 cases among 48 900 necropsies. Cancer, 1954, 7(3): 462-503.
19. Li N, Lai EC, Shi J, et al. A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection. Ann Surg Oncol, 2010, 17(1): 179-185.
20. Piao CY, Fujioka S, Iwasaki Y, et al. Lamivudine treatment in patients with HBV-related hepatocellular carcinoma—using an untreated, matched control cohort. Acta Med Okayama, 2005, 59(5): 217-224.
21. Yeo W, Chan PK, Zhong S, et al. Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemo-therapy: a prospective study of 626 patients with identification of risk factors. J Med Virol, 2000, 62(3): 299-307.
22. Yeo W, Lam KC, Zee B, et al. Hepatitis B reactivation in patients with hepatocellular carcinoma undergoing systemic chemotherapy. Ann Oncol, 2004, 15(11): 1661-1666.
23. Lim LL, Wai CT, Lee YM, et al. Prophylactic lamivudine prevents hepatitis B reactivation in chemotherapy patients. Aliment Pharmacol Ther, 2002, 16(11): 1939-1944.
24. Kubo S, Nishiguchi S, Hamba H, et al. Reactivation of viral replication after liver resection in patients infected with hepatitis B virus. Ann Surg, 2001, 233(1): 139-145.
25. Huang G, Lai EC, Lau WY, et al. Posthepatectomy HBV reactivation in hepatitis B-related hepatocellular carcinoma influences postoperative survival in patients with preoperative low HBV-DNA levels. Ann Surg, 2013, 257(3): 490-505.

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Observation of hepatitis B reactivation within 1 month after partial hepatectomy

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