title: Risk of hepatitis B exacerbation is low after transcatheter arterial chemoembolization therapy for patients with HBV-related hepatocellular carcinoma: report of a prospective study.
abstract: 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.
authors.affiliation: Center for Liver Cancer and Center for Clinical Services, Goyang, South Korea.
authors.forename: Joong-Won
authors.initials: JW
authors.lastname: Park
authors.forename: Kyung Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Sang Hyung
authors.initials: SH
authors.lastname: Cho
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Lee
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Lee
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Kim
mesh_terms: 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
chemical_list: D006514:Hepatitis B Surface Antigens