These authors contributed equally to this study.
Changes in hepatitis B virus DNA levels and liver function after transcatheter arterial chemoembolization of hepatocellular carcinoma
Article first published online: 29 MAR 2011
© 2011 The Japan Society of Hepatology
Volume 41, Issue 6, pages 553–563, June 2011
How to Cite
Lao, X.-M., Wang, D., Shi, M., Liu, G., Li, S., Guo, R., Yuan, Y., Chen, M., Li, J., Zhang, Y. and Lin, X. (2011), Changes in hepatitis B virus DNA levels and liver function after transcatheter arterial chemoembolization of hepatocellular carcinoma. Hepatology Research, 41: 553–563. doi: 10.1111/j.1872-034X.2011.00796.x
- Issue published online: 25 MAY 2011
- Article first published online: 29 MAR 2011
- Received 31 August 2010; revision 10 February 2011; accepted 16 February 2011.
- hepatitis B virus reactivation;
- hepatitis B virus DNA;
- hepatocellular carcinoma;
- liver function;
- transcatheter arterial chemoembolization
Aim: Reports concerning changes in hepatitis B virus (HBV) status and liver function in hepatocellular carcinoma (HCC) during or after transcatheter arterial chemoembolization (TACE) have been rare and the results inconsistent. The objective of this retrospective study was to evaluate these parameters in a large cohort of HBV-related HCC patients.
Methods: One hundred and seventy-two hepatitis B surface antigen positive HCC patients with Child–Pugh grade A or B liver disease who underwent 228 sessions of TACE were enrolled, and related clinical and laboratory data were analyzed.
Results: In total, HBV reactivated in 33 (14.5%), remained stable in 152 (66.7%) and decreased in 43 (18.8%) sessions. Univariate analysis revealed that sex and HBV DNA levels correlated with changes in HBV DNA status after TACE, while hepatitis B e-antigen (HBeAg), prothrombin time and chemotherapeutic agents were marginally significant factors. Multivariate analysis demonstrated that the major factors that influenced the HBV DNA status were baseline HBV DNA levels(P = 0.0002) and HBeAg (P = 0.0387). A comparison of the post-TACE (30–90 days) liver function to the baseline revealed no significant differences. The reactivation group has the highest rate of exacerbation (12.1%) compared with the stable group (5.9%) and downregulation group (4.7%).
Conclusion: HBV DNA changes after TACE included reactivated, decreased and stable HBV DNA levels. Although HBV reactivation did not necessarily result in exacerbation of liver damage and most HCC patients with Child–Pugh grade A and B tolerated TACE well, careful post-procedure monitoring and managing is needed.