Effects of antiviral therapy on post-hepatectomy HBV reactivation and liver function in HBV DNA-negative patients with HBV-related hepatocellular carcinoma
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Wen-Feng Gong1,2,*, Jian-Hong Zhong1,2,*, Shi-Dong Lu1,2, Xiao-Bo Wang1,2, Qiu-Ming Zhang3, Liang Ma1,2, Zhi-Ming Zhang1,2, Bang-De Xiang1,2, Le-Qun Li1,2
1Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
2Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning 530021, China
3General Medicine Department, The First People Hospital of Qinzhou, Qinzhou, 535000, China
*These authors contributed equally to this work and as co-first authors
Le-Qun Li, email: [email protected]
Bang-De Xiang, email: [email protected]
Keywords: hepatocellular carcinoma, hepatitis B virus, antiviral, reactivation, liver function
Received: November 30, 2016 Accepted: January 11, 2017 Published: January 21, 2017
The ability of antiviral therapy to reduce risk of post-hepatectomy hepatitis B virus (HBV) reactivation in patients negative for viral DNA is unclear. This prospective study involved 174 consecutive patients with hepatitis B virus related hepatocellular carcinoma who were negative for hepatitis B virus DNA in serum and who underwent hepatic resection. Hepatitis B virus reactivation occurred in 30 patients in the non-antiviral group (27.8%) but in only 2 patients in the antiviral group (3.0%, P < 0.001). Based on multivariate analysis, risk of hepatitis B virus reactivation was associated with minor hepatectomy and absence of antiviral therapy. Liver function indicators at one week after resection did not differ significantly between the two groups, or between patients who experienced hepatitis B virus reactivation or not. Nevertheless, alanine aminotransferase and albumin at 1 month after resection were significantly higher in the antiviral group than in the non-antiviral group, and they were significantly higher in patients who did not experience hepatitis B virus reactivation than in those who did. Therefore, patients with hepatitis B virus related hepatocellular carcinoma face substantial risk of hepatitis B virus reactivation after hepatectomy, even if they are negative for viral DNA at baseline. Antiviral therapy can reduce the risk of reactivation, helping improve liver function after surgery. (Clinicaltrials.gov registration number: NCT02829359).
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