Antiviral Therapy Effect On HBV Reactivation In Patients Receiving Cancer Chemotherapy/Immunosuppressant And Analysis Of Releated Risk Factors Of HBV Reactivation

Purpoes Obeseration in hepatitis B virus reactivation on oral nucleoside analogueantiviral therapy with HBV infection in patients receiving chemotherapy/immunosuppressive,and to further explore the role of nucleoside analogue prevention andtreatment of HBV reactivation, as well the risk factors of HBV reactivation for thesepatients,and provid evidence-based for those patients more extensive use of nucleosideanalogues in clinic.Method Collected in our hospital during from2008to2012receivngchemotherapy/immunosuppressant therapy and merger in HBV of305patient. according tochemotherapy/immunosuppressant therapy before it accept antiviral drugs divided intoprevention and control group. Prevent group of145case, Among the control group.160cases, Obesration two groups in the field of activate HBV rate, incidence of abnormal liverfunction, and the clinical progress rate have or on difference。 After HBV reactivationwhether or not add nucleoside analogues divided the delay antiviral treatment group anddelay non-antiviral treatment group in the controls groups, further analysis extension ofHBV antiviral treatment not activate after the curative effect; On the basis of the above workto continue to explore the related risk factors of.HBV reactivateResult： Prevention of group14patients (9.65%,14/145) HBV-DNA elevation and incontrast with68cases in the control group (42.5%,68/160) had significant difference(P<0.05); prevention group in the treatment of first,3,6,9,12and15months, the totalHBV-DNA reactivation rate were0.7%3.4%7.58%8.27%9.65%9.65%, significantly lowerthan in the control group, two groups had significant difference (P<0.05); Prevention ofgroup after treatment of AST, ALT, ALB, TBIL compared with the control group hagsignificant difference (P<0.05);The control group AST ALT, TBIL were significantlyincreased, ALB decreased significantly after treatment, there were significant differencesbetween before and after treatment (P<0.05);along with chemotherapy and immunityinhibitor cumulative dose increased, the prevention group and control group the incidence ofabnormal liver function gradually increased, in the prevention group1,3,6,9,12,15months ofabnormal liver function occurred at a rate of1.37%,5.51%,6.2%,2.8%,1.37%were significantly lower than the control group, two groups had significant difference (P<0.05);prevention group6cases (4.14%,6/145) had clinical progress and in contrast to32cases inthe control group (21.2%,32/160) had significant difference (P<0.05).Delayed antiviraltherapy liver AST, ALT, ALB group, TBIL in contrast to non-antiviral treatment group hada significant difference (P<0.05);antiviral therapy after3months, delayed antiviral therapygroups of AST, ALT, ALB, TBIL is activated when a significantly better, compared twogroups had significant difference (P<0.05),;delay antiviral treatment group15patients(35.7%,15/42) the emergence of clinical progress and in contrast to non-antiviral treatmentgroup of17cases (65.3%.17/26) had significant difference (P<0.05). in46cases(51.7%,46/89) male HBV reactivation in contrast to22cases (30.9%,22/71) women hadsignificant difference (P<0.05); HBV-DNA<103copies/ml group and HBV-DNA≥104copies/ml group compared with HBV reactivation rates have significant difference(P<0.05); in28cases (58.3%,28/48) HBeAg patients with positive HBV reactivation and incontrast to28cases (35.5%,28/79) HBeAg negative had significant difference (P<0.05); lessthan45years old in46patients (52.9%,46/87) HBV reactivation and in contrast to agegreater than45years22cases (29.1%,22/73) had significant difference (P<0.05);ALT<35IU/L in32patients (33.7%,32/95) had HBV activation and in contrast withALT>35IU/L36(55.4%,36/65) cases, had a significant difference (P<0.05).Conclusion： Prophylactic of oral antiviral drugs can effectively prevent HBVreactivation,make in the prossess of chemotherapy/immunosuppressants smoothly. afterdelayed antiviral therapy is superior to the after non-antiviral treatment in HBVreactivation. receiveing chemotherapy/immunosuppressive therapy with HBV infectionin patients before treatment, patients were male, aged less than45years-old, HBeAg positive,HBV-DNA>104copies/ml, ALT>35IU/Lwere the risk factors in HBV reactivation.