title: Transarterial chemo-lipiodolization can reactivate hepatitis B virus replication in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Reactivation of hepatitis B virus (HBV) replication is a well-known complication in cancer patients receiving chemotherapy. The aims of this study were to determine the incidence of HBV reactivation in hepatocellular carcinoma (HCC) patients undergoing transarterial chemo-lipiodolization, and to clarify factors contributing to HBV reactivation.
  
  
  METHODS
  From April 2001 to September 2002, 146 HBsAg positive patients newly diagnosed as HCC were enrolled in the study. Among these, 83 patients underwent transarterial chemo-lipiodolization using epirubicin and/or cisplatin, and 63 received other treatments.
  
  
  RESULTS
  In total, HBV reactivation occurred in 30 (20.5%) patients (28 with chemo-lipiodolization and 2 with other treatments), and of the 30 patients, 19 (13.0%) (18 with chemo-lipiodolization and 1 with other treatments) developed hepatitis. Chemo-lipiodolization was significantly correlated with a higher incidence of hepatitis attributed to HBV reactivation than other treatments (21.7% vs. 1.6%, P<0.001), irrespective of HBeAg or HBV DNA. Among 83 patients undergoing chemo-lipiodolization, HBV reactivation occurred in 28 (33.7%) patients, and HBeAg seropositivity was the only independent predictor of HBV reactivation (P=0.013). Three (10.7%) of them died of hepatic decompensation resulting from HBV reactivation.
  
  
  CONCLUSIONS
  Transarterial chemo-lipiodolization can reactivate HBV, and HBeAg-positive HCC patients receiving chemo-lipiodolization should be closely monitored for HBV reactivation.
authors.affiliation: Division of Hepatology, Department of Internal Medicine, College of Medicine, WHO collaborating Center on Viral Hepatitis, Catholic University of Korea, #505 Banpodong, Seocho-ku, 137-040 Seoul, South Korea.
authors.forename: Jeong Won
authors.initials: JW
authors.lastname: Jang
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Si Hyun
authors.initials: SH
authors.lastname: Bae
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Kim
authors.forename: Seung Kew
authors.initials: SK
authors.lastname: Yoon
authors.forename: Se Hyun
authors.initials: SH
authors.lastname: Cho
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Yang
authors.forename: Byung Min
authors.initials: BM
authors.lastname: Ahn
authors.forename: Chang Don
authors.initials: CD
authors.lastname: Lee
authors.forename: Young Sok
authors.initials: YS
authors.lastname: Lee
authors.forename: Kyu Won
authors.initials: KW
authors.lastname: Chung
authors.forename: Hee Sik
authors.initials: HS
authors.lastname: Sun
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006515:Hepatitis B virus / Q000187:drug effects; D019694:Hepatitis B, Chronic / Q000150:complications / Q000209:etiology* / Q000821:virology; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D015251:Epirubicin; D007459:Iodized Oil; D002945:Cisplatin