title: High hepatitis B virus DNA level in serum before liver transplantation increases the risk of hepatocellular carcinoma recurrence.
abstract: OBJECTIVE
  To analyze the relationship between hepatitis B virus (HBV) and hepatocellular carcinoma (HCC) recurrence in orthotopic liver transplantation (OLT) patients.
  
  
  METHODS
  340 HBV patients with OLT were included in the study; among them were 148 patients with HBV-associated HCC.
  
  
  RESULTS
  HCC recurrence rates at 1, 3 and 5 years were 21, 29, and 46%, respectively. Exceeding Milan criteria (hazard ratio, HR = 12.35; 95% confidence interval, CI, 2.80-54.49; p = 0.001), HBV DNA level >5 log(10) copies/ml before transplant (HR = 2.45; 95% CI 1.10-5.45; p = 0.03) and HBV recurrence (HR = 2.27; 95% CI 1.10-4.75; p = 0.03) were significant independent predictors of HCC recurrence. HBV DNA >5 log(10) copies/ml before transplant (HR = 8.65; 95% CI 3.40-21.98; p < 0.001) and concomitance with HCC (HR = 2.79; 95% CI 1.33-5.87; p = 0.007) were predictors of HBV recurrence. Further stratified analysis showed that HBV recurrence was more prevalent in the HCC recurrence group (HR = 4.58; 95% CI 1.88-11.12; p = 0.001).
  
  
  CONCLUSIONS
  There is a close relationship between HBV and HCC recurrence after transplant. High HBV DNA levels before transplant are associated with HCC recurrence after transplant.
authors.affiliation: Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. liminru@163.com
authors.forename: Min-ru
authors.initials: MR
authors.lastname: Li
authors.forename: Gui-hua
authors.initials: GH
authors.lastname: Chen
authors.forename: Chang-jie
authors.initials: CJ
authors.lastname: Cai
authors.forename: Guo-ying
authors.initials: GY
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery / Q000821:virology*; D002648:Child; D004279:DNA, Viral / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D006515:Hepatitis B virus; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery / Q000821:virology*; D016031:Liver Transplantation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000821:virology*; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D019562:Viral Load; D055815:Young Adult
chemical_list: D004279:DNA, Viral