Potential risk factors for the reactivation of the replication of hepatitis B and C viruses after transcatheter arterial chemoembolization of hepatocellular carcinoma.
The purpose of this study was to investigate the potential risk factors for the reactivation of the replication of hepatitis B virus (HBV) and hepatitis C virus (HCV) after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma. Forty-four hepatocellular carcinoma patients treated by TACE using epirubicin plus mitomycin C were studied. Serum HBV DNA (n=17) and HCV RNA (n=27) levels were measured 1 day before and 3 months after TACE. Plasma concentrations of chemotherapeutic agents were determined at 1 hour and 72 hours after TACE. A total of 29 patients (n=13 for chronic hepatitis Band n=16 for chronic hepatitis C) showed significant changes of the viral loads after TACE. Patients with increased viral loads after TACE were older (p=0.041), had higher incidence of pre-TACE white blood cell counts being less than normal limit (p=0.023), and had higher plasma mitomycin C concentrations (p=0.039) than those in patients with decreased viral loads. Analysis by multiple logistic regressions using age, decreased or normal pre-TACE white blood cell counts, mitomycin C concentrations >3.95 ng/mL adopted by receiver operating characteristic curve (p=0.037), and epirubicin concentrations have shown that decreased pre-TACE white blood cell counts was the only significant factor associated with increased viral loads after TACE (p=0.048). In conclusion, patients with decreased pre-TACE white blood cell counts have a potential risk for the reactivation of the replication of HBV or HCV after TACE.
Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Chia-I
CI
Lin
Zu-Yau
ZY
Lin
Ming-Yen
MY
Hsieh
Chung-Feng
CF
Huang
Su-Hwei
SH
Chen
Wan-Long
WL
Chuang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000628:therapy* / Q000821:virology; D016461:Chemoembolization, Therapeutic; D004279:DNA, Viral / Q000097:blood; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D016174:Hepacivirus / Q000502:physiology*; D006515:Hepatitis B virus / Q000502:physiology*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000821:virology*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000821:virology*; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000097:blood / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D016017:Odds Ratio; D012367:RNA, Viral / Q000097:blood; D012372:ROC Curve; D012307:Risk Factors; D019562:Viral Load / Q000187:drug effects; D014775:Virus Activation; D014779:Virus Replication
D004279:DNA, Viral; D012367:RNA, Viral; D015251:Epirubicin; D016685:Mitomycin