Postoperative HBV Reactivation In Hepatocellular Carcinoma Patients With HBV-DNA Levels Less Than The Minimum Standard

Objective:This study aimed to clarify the incidence of postoperative hepatitis B virus (HBV) reactivation and its risk factors in hepatocellular carcinoma (HCC) patients with HBV-DNA levels< 500 IU/ml. Thus, to figure out the significance of antiviral therapy on liver function recovery after hepatectomy.Methods:In this prospective study, 74 patients with preoperative HBV-DNA levels< 500 IU/mL scheduled for hepatectomy to treat HBV-related HCC were analyzed. Patients were divided into 2 groups depending on antiviral therapy, 20 HCC patients were given antiviral therapy at least 3 days before hepatectony, and another 54 HCC patients were not given antiviral therapy. Postoperative reactivation was defined as positive postoperative HBV-DNA within 7 days. Statistics were using software SPSS 22.0.Results:Of the 74 HCC patients enrolled,16 (21.6%) HCC patients suffered PHR. None serious adverse events and no perioperative death was detected. Among 54 HCC patients who were not given preoperative antiviral therapy,15 (27.0%) patients suffered PHR. While only 1 patient suffered PHR among 20 HCC patients who were given preoperative antiviral therapy (P=0.004). The following were identified as independent risk factors for PHR: no preoperative antiviral therapy (OR= 13.952, P=0.027). Albumin (P=0.016), alanine aminotransferase (P=0.048) for PHR patients indicated a slower recovery than non-PHR patients. Patients with preoperative antiviral therapy had a faster recovery of albumin (P=0.035).Conclusion:HCC patients with HBV-DNA less than minimum standard has the risk of postoperative HBV reactivation. Antiviral therapy is needed for them. No preoperative antiviral therapy were independent risk factors contributed to PHR. Preoperative antiviral therapy could significantly decreased the incidence of PHR, which may also improve liver function than patients without preoperative antiviral therapy as well.