Impact of postoperative hepatitis <scp>B</scp> virus reactivation in hepatocellular carcinoma patients who formerly had naturally suppressed virus

Lee, Jung Il; Kim, Ja Kyung; Chang, Heon-Young; Lee, Jin Woo; Kim, Joon Mee; Chung, Hyun Jung; Kim, Young Soo; Lee, Kwan Sik

doi:10.1111/jgh.12472

Cited by 13 publications

(24 citation statements)

References 25 publications

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“…While several nucleot(s) ide analogues are in wide clinical use, entecavir has higher potency and is associated with lower risk of resistance, potentially making it more effective for many patients . Our use of entecavir in the present study may help explain why our rate of PHR was lower than that in several other studies .…”

Section: Discussionmentioning

confidence: 62%

“…In that study, the rate of PHR was significantly lower among those on antiviral therapy (4.7%) than among those not receiving such therapy (20.6%), which is similar to our results. Other studies have consistently shown that antiviral therapy can significantly reduce risk of PHR . A meta‐analysis showed that antiviral therapy with nucleot(s) ide analogues reduces risk of death and of HCC recurrence in patients with HBV‐related HCC following curative treatment, despite a high frequency of lamivudine resistance.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative hepatitis B virus reactivation and surgery‐induced immunosuppression in patients with hepatitis B‐related hepatocellular carcinoma

Xie

Zhu

Peng

et al. 2015

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Postoperative hepatitis B virus reactivation and surgery‐induced immunosuppression in patients with hepatitis B‐related hepatocellular carcinoma

Xie

Zhu

Peng

et al. 2015

Journal of Surgical Oncology

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“…Lee et al . reported that postoperative HBV reactivation was associated with HCC recurrence after surgical resection (including large tumour and multinodularity) in patients with CHB (including both high and low viral loads). Huang et al .…”

Section: Discussionmentioning

confidence: 99%

“…However, there are a few studies investigating whether or not HBV reactivation influences the risk of HCC recurrence after resection. Lee et al [27] reported that postoperative HBV reactivation was associated with HCC recurrence after surgical resection (includ-ing large tumour and multinodularity) in patients with CHB (including both high and low viral loads). Huang et al [25] also showed that HBV reactivation was a risk factor for the recurrence of HCC after surgical resection (including large tumour and multinodularity) in patients with low viral loads (<2000 IU/mL).…”

Section: Discussionmentioning

confidence: 99%

Influence of hepatitis B virus reactivation on the recurrence of HBV‐related hepatocellular carcinoma after curative resection in patients with low viral load

Sohn

Paik

Cho

et al. 2014

Journal of Viral Hepatitis

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It is unclear whether the reactivation of hepatitis B virus (HBV) influences the prognosis of hepatocellular carcinoma (HCC) after resection in patients with chronic hepatitis B. The aim of this study was to identify the influence of HBV reactivation on the recurrence of hepatitis B-related HCC after curative resection in patients with low viral load (HBV DNA <2000 IU/mL). We retrospectively analysed a total of 130 patients who underwent curative resection for HBV-related early stage HCC (single nodule; <5 cm/two or three nodules; <3 cm) with pre-operative HBV DNA levels <2000 IU/mL with serial HBV DNA tests. The predictive factors including HBV reactivation for the recurrence of HBV-related HCC after curative resection were investigated. Fifty-three patients (41%) had HBV reactivation after resection among 130 patients. HBV reactivation was observed in 22 of 53 patients with undetectable baseline HBV DNA and in 31 of 77 patients with detectable baseline HBV DNA. Cumulative recurrence rates after resection at 1, 2 and 3 years were 17.0%, 23.3% and 31.4%, respectively. The multivariable analysis demonstrated that the risk factors for the recurrence were the presence of microvascular invasion (hazard ratio (HR) 2.62, P = 0.003), multinodularity (HR 4.61, P = 0.005), HBV reactivation after resection (HR 2.03, P = 0.032) and HBeAg positivity (HR 2.06, P = 0.044). HBV reactivation after curative resection is associated with the recurrence of HBV-related HCC in patients with low viral load.

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“…Even for patients with low HBV DNA levels, there is still a risk of postoperative reactivation [44,45] . HBV reactivation may worsen liver function, but has also been associated with recurrence of HCC for those with low viral load at baseline [46] .…”

Section: Antiviral Therapy For Hcc Patients Undergoing Surgical Resecmentioning

confidence: 99%

The role of oral antiviral therapy in hepatitis B-related hepatocellular carcinoma

Fung¹,

Chok²

2017

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Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) in places where chronic hepatitis B infection is endemic. Oral nucleos(t)ide analog (NA) therapy can reduce the risk of HCC, but cannot completely prevent its development. For HBV-related HCCs, viral inhibition by NAs can preserve or improve liver function, thereby increasing the chance of therapeutic intervention. After surgical resection, NAs can prevent reactivation of HBV, and also reduce the chance of de novo development of HCC in the remnant liver. For those who undergo liver transplantation, NAs are essential to prevent reactivation and graft hepatitis, but is not likely to prevent HCC recurrence, which is due to metastatic disease. The role of NAs for non-curable advanced HCC is less well defined. These include patients undergoing locoregional therapy, chemotherapy, or palliation. Although antiviral therapy can preserve liver function, which may be compromised by HBV, it is unable to prevent disease progression from HCC. At the time of HCC diagnosis, most patients will already be receiving NAs, and these patients should be maintained on therapy. For patients not on antiviral therapy at the time of HCC diagnosis, the decision to commence therapy is often determined by the stage of HCC and life expectancy. Patients undergoing curative therapy, or locoregional therapy/chemotherapy with reasonable life expectancy, should be commenced on antiviral therapy. Key words:Antiviral therapy, hepatitis B virus, hepatocellular carcinoma ABSTRACTArticle history:

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Impact of postoperative hepatitis B virus reactivation in hepatocellular carcinoma patients who formerly had naturally suppressed virus

Abstract: This study shows that naturally suppressed preoperative HBV without application of antiviral agent does not ensure undetectable serum HBV after the surgery, and postoperative viral reactivation might be associated with HCC recurrence.

Cited by 13 publications

References 25 publications

Postoperative hepatitis B virus reactivation and surgery‐induced immunosuppression in patients with hepatitis B‐related hepatocellular carcinoma

Postoperative hepatitis B virus reactivation and surgery‐induced immunosuppression in patients with hepatitis B‐related hepatocellular carcinoma

Influence of hepatitis B virus reactivation on the recurrence of HBV‐related hepatocellular carcinoma after curative resection in patients with low viral load

The role of oral antiviral therapy in hepatitis B-related hepatocellular carcinoma

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