title: Changes in hepatitis B virus DNA levels and liver function after transcatheter arterial chemoembolization of hepatocellular carcinoma.
abstract: OBJECTIVE
  Reports concerning changes in hepatitis B virus (HBV) status and liver function in hepatocellular carcinoma (HCC) during or after transcatheter arterial chemoembolization (TACE) have been rare and the results inconsistent. The objective of this retrospective study was to evaluate these parameters in a large cohort of HBV-related HCC patients.
  
  
  METHODS
  One hundred and seventy-two hepatitis B surface antigen positive HCC patients with Child-Pugh grade A or B liver disease who underwent 228 sessions of TACE were enrolled, and related clinical and laboratory data were analyzed.
  
  
  RESULTS
  In total, HBV reactivated in 33 (14.5%), remained stable in 152 (66.7%) and decreased in 43 (18.8%) sessions. Univariate analysis revealed that sex and HBV DNA levels correlated with changes in HBV DNA status after TACE, while hepatitis B e-antigen (HBeAg), prothrombin time and chemotherapeutic agents were marginally significant factors. Multivariate analysis demonstrated that the major factors that influenced the HBV DNA status were baseline HBV DNA levels(P = 0.0002) and HBeAg (P = 0.0387). A comparison of the post-TACE (30-90 days) liver function to the baseline revealed no significant differences. The reactivation group has the highest rate of exacerbation (12.1%) compared with the stable group (5.9%) and downregulation group (4.7%).
  
  
  CONCLUSIONS
  HBV DNA changes after TACE included reactivated, decreased and stable HBV DNA levels. Although HBV reactivation did not necessarily result in exacerbation of liver damage and most HCC patients with Child-Pugh grade A and B tolerated TACE well, careful post-procedure monitoring and managing is needed.
authors: Department of Hepatobilliary Oncology, Sun Yat-sen University Cancer Center and State Key Laboratory of Southern China, Guangzhou, China Department of Surgical Oncology of University of Michigan University of Michigan, Ann Arbor, Michigan, USA.
authors: Xiang-Ming
authors: XM
authors: Lao
authors: Dian
authors: D
authors: Wang
authors: Ming
authors: M
authors: Shi
authors: Guipeng
authors: G
authors: Liu
authors: Shengping
authors: S
authors: Li
authors: Rongping
authors: R
authors: Guo
authors: Yunfei
authors: Y
authors: Yuan
authors: Minshan
authors: M
authors: Chen
authors: Jinqing
authors: J
authors: Li
authors: Yaqi
authors: Y
authors: Zhang
authors: Xiaojun
authors: X
authors: Lin