title: The influence of hepatitis B DNA level and antiviral therapy on recurrence after initial curative treatment in patients with hepatocellular carcinoma.
abstract: BACKGROUND
  Prediction and prevention of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) recurrence is an important clinical issue. We investigated whether HBV DNA level and antiviral therapy are associated with HCC recurrence.
  
  
  METHODS
  This retrospective study involved 103 patients who underwent hepatic resection or radiofrequency ablation for initial HCC. Patients were divided into four groups. Thirty had high serum HBV DNA levels (>4 log(10) copies/mL) and had not received antiviral therapy (high virus group; HVG). Thirty-four had low HBV DNA levels (< or =4 log(10) copies/mL) and had not received antiviral therapy (low virus group; LVG). Twenty received antiviral therapy after HCC developed (therapeutic group A, TG-A). Nineteen received antiviral therapy before HCC developed (therapeutic group B, TG-B).
  
  
  RESULTS
  Cumulative HCC recurrence rates at 3 years in the HVG, LVG, TG-B, and TG-A were 71.1%, 42.2%, 42.3%, and 52.0%, respectively. Recurrence rates differed significantly between the HVG and LVG (P = 0.016) and between the HVG and TG-B (P = 0.008). Recurrence rate in the TG-A was marginally lower than in the HVG (P = 0.10). On multivariate analysis, high serum hepatitis B virus DNA levels (hazard ratio: HR 2.67; 95% CI 1.31-5.47; P = 0.007) and absence of antiviral therapy (HR 2.57; 95% CI 1.34-4.94; P = 0.005) were independent risk factors for hepatocellular carcinoma recurrence.
  
  
  CONCLUSIONS
  HBV DNA level and antiviral therapy are associated with HCC recurrence. For patients with high HBV DNA levels, antiviral therapy before the development of HCC is important for prevention of recurrence.
authors: Department of Gastroenterology and Hematology, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan. mchuuma@med.hokudai.ac.jp
authors: Makoto
authors: M
authors: Chuma
authors: Shuhei
authors: S
authors: Hige
authors: Toshiya
authors: T
authors: Kamiyama
authors: Takashi
authors: T
authors: Meguro
authors: Atsushi
authors: A
authors: Nagasaka
authors: Kazuaki
authors: K
authors: Nakanishi
authors: Yoshiya
authors: Y
authors: Yamamoto
authors: Mitsuru
authors: M
authors: Nakanishi
authors: Toshihisa
authors: T
authors: Kohara
authors: Takuya
authors: T
authors: Sho
authors: Keiko
authors: K
authors: Yamamoto
authors: Hiromasa
authors: H
authors: Horimoto
authors: Tomoe
authors: T
authors: Kobayashi
authors: Hideki
authors: H
authors: Yokoo
authors: Michiaki
authors: M
authors: Matsushita
authors: Satoru
authors: S
authors: Todo
authors: Masahiro
authors: M
authors: Asaka
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000503:physiopathology* / Q000628:therapy / Q000821:virology; D017115:Catheter Ablation; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D008113:Liver Neoplasms / Q000503:physiopathology* / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral