title: Postoperative hepatitis B virus reactivation and surgery-induced immunosuppression in patients with hepatitis B-related hepatocellular carcinoma.
abstract: BACKGROUND
  Hepatectomy in hepatocellular carcinoma (HCC) patients lead to postoperative hepatitis B virus (HBV) reactivation (PHR) as well as immunosuppression.
  
  
  METHODS
  This prospective study involved 135 HBV-related HCC patients and 42 control hepatic hemangioma patients.
  
  
  RESULTS
  Among HCC patients, 26 (19.3%) suffered PHR. Risk factors for PHR were HBV-cAg S1 positivity [hazard ratio (HR) = 404.82, P = 0.004], high preoperative total bilirubin level (HR = 186.38, P = 0.036), small preoperative proportions of CD3-CD16 + CD56 + cells (HR = 0.01, P = 0.014) and CD19 + B cells (HR = 0.02, P = 0.016), blood transfusion (HR = 157.03, P = 0.006) and high liver cirrhosis S score (HR = 270.45, P = 0.004). On postoperative day (POD) 3, PHR patients showed much greater immunosuppression than non-PHR patients based on proportions of T cells (CD3+, CD3 + CD4+, CD3 + CD8+), B cells (CD19+) and on levels of IgG, IgA antibodies, complement proteins C3, and C4. By POD 7, PHR patients had partially recovered but not as quickly as non-PHR patients: PHR patients still showed deficits in T cells (CD3+, CD3 + CD4+), CD3-CD16 + CD56+ cells and in levels of IgM, C3, C4, and C-reactive protein.
  
  
  CONCLUSIONS
  PHR may be associated with resection-induced immunosuppression in patients with HBV-related HCC.
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.|Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Zhi-Bo
authors.initials: ZB
authors.lastname: Xie
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Zhu
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.
authors.forename: Yu-Chong
authors.initials: YC
authors.lastname: Peng
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.|Department of Hepatobiliary Surgery, Affiliated Minzu Hospital of Guangxi Medical University, Nanning, P.R. China.
authors.forename: Xiao-Bo
authors.initials: XB
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, P.R. China.
authors.forename: Liang
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, P.R. China.
authors.forename: Tao
authors.initials: T
authors.lastname: Bai
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, P.R. China.
authors.forename: Bang-De
authors.initials: BD
authors.lastname: Xiang
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, P.R. China.
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, P.R. China.|Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, P.R. China.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Zhong
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D007165:Immunosuppression Therapy; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D019562:Viral Load; D014775:Virus Activation
keywords: hepatitis B virus; hepatocellular carcinoma; immune function; postoperative reactivation; surgery