Risk of hepatitis B exacerbation is low after transcatheter arterial chemoembolization therapy for patients with HBV-related hepatocellular carcinoma: report of a prospective study.
OBJECTIVE
Systemic chemotherapy may lead to immune suppression and possible reactivation of hepatitis B virus (HBV), suggesting prophylactic antiviral therapy in cancer patients with HBV. Transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is not a systemic chemotherapy, but has been partially associated with HBV reactivation. The aim of this study was to evaluate whether TACE aggravates HBV hepatitis in patients with HBV-related HCC.


METHODS
Eighty-nine patients with HBV-related HCC were studied prospectively. Patients treated with TACE were enrolled in the case group (n = 69), and patients in follow-up or awaiting treatment were enrolled in the control group (n = 20). TACE was performed with doxorubicin (20-60 mg) and lipiodol (2-20 mL).


RESULTS
Three (4.3%) patients in the TACE group and 2 (10%) patients in the control group showed HBV reactivation (p= 0.334). A twofold or more increase in serum HBV DNA was detected in 21 (30.4%) patients in the TACE group and 4 (20%) patients in the control group (p= 0.361). Exacerbation of viral hepatitis B was found in 4 (5.8%) patients in the TACE group and no patients in the control group, but the difference between the two rates was not statistically significant (p= 0.271). Three of the four reactivated patients showed spontaneous recovery within 1 month, and one showed tumor-progression-related exacerbation.


CONCLUSIONS
One session of TACE using doxorubicin and lipiodol does not significantly aggravate HBV hepatitis in patients with HBV-related HCC.
Park
Joong-Won
JW
Center for Liver Cancer and Center for Clinical Services, Goyang, South Korea.
Park
Kyung Woo
KW
Cho
Sang Hyung
SH
Park
Hong Suk
HS
Lee
Woo Jin
WJ
Lee
Do Hoon
DH
Kim
Chang-Min
CM
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000628:therapy* / Q000821:virology; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014775:Virus Activation
D006514:Hepatitis B Surface Antigens