Hepatitis B virus reactivation in patients with hepatocellular carcinoma undergoing anti-cancer therapy

Table 1 Results of hepatitis B virus reactivation in patients with hepatocellular carcinoma receiving chemotherapy n (%)

Ref.	No of patients	Chemotherapy	No of sessions	HBV reactivation (hepatitis)1	Morbidity/mortality
Nagamatsu et al[29]	33	TAI	Weekly infusion	24%	3 died
Jang et al[27]	146	TACL	5 (2-14)	33.7% (21.7%)	25 resolved, 3 died
Nagamatsu et al[10]	17	TAI	bi-weekly infusion	67%	3 died of HBV reactivation
Yeo et al[15]	102	Systemic chemotherapy	3-weekly intervals	(36%)	Twelve died of HBV reactivation
Park et al[31]	89	TACE	1	4.3%	3 resolved, 1 had tumor-related hepatic failure
Jang et al[17]	73	TACL	1-monthly intervals	40.5% (29.7%)	One died of HBV reactivation
Kim et al[6]	91	TACE + RT	NA	21.8% (a rebound of HBV DNA to > 100 × baseline)	4 (12.5) developed CHB exacerbation
Lao et al[32]	172	TACE	1.3/person	14.5%	12.1% in the reactivation group had CHB exacerbation
Jang et al[7]	205	LAT, TACL, TACL + RT	1-2 monthly intervals	30.2%	10 developed decompensation, 1 died
Lao et al[30]	320	TACE	4-10 weekly intervals	17.5%	26 (8.1) had liver functional deterioration

¹The rates of hepatitis B virus (HBV) reactivation were the frequencies in antiviral-untreated patients. Modified from Jang et al[8]. HCC: Hepatocellular carcinoma; TAI: Transarterial infusion chemotherapy; TACL: Transarterial chemo-lipiodolization; TACE: Transarterial chemo-embolization; RT: Radiotherapy; LAT: Local ablation therapy.

Table 2 Results of hepatitis B virus reactivation in patients with hepatocellular carcinoma receiving hepatectomy n (%)

Ref.	No of patients	HBV reactivation1	Morbidity/mortality
Kubo et al[36]	25	28.0%	24% had postoperative hepatitis
Huang et al[35]	164	21.1%	No patient developed liver failure postoperation
Huang et al[37]	84	31.8%	8.3% had postoperative liver insufficiency
Dan et al[38]	93	14.0%	25% developed hepatitis, None of them developed hepatic failure
Lao et al[30]	121	15.7%	26 (8.1) had liver functional deterioration

¹The rates of hepatitis B virus (HBV) reactivation were the frequencies in antiviral-untreated patients.

Table 3 Results of hepatitis B virus reactivation in patients with hepatocellular carcinoma receiving local ablation therapy

Ref.	No of patients	Therapy	HBV reactivation (hepatitis)1	Morbidity/mortality
Jang et al[7]	43	7 with PEIT and 36 with RFA	0% vs 9.1% in patients with low and high viremia, respectively	None of the patients developed hepatic decompensation
Yoshida et al[39]	104	RFA	(5.6%)	Not specified
Dan et al[38]	125	RFA	5.6%	None of the patients developed hepatic failure

¹The rates of hepatitis B virus (HBV) reactivation were the frequencies in antiviral-untreated patients. RFA: Radiofrequency ablation.

Table 4 Clinical trials of preemptive antiviral therapy for hepatitis B virus reactivation in patients with hepatitis B virus-related hepatocellular carcinoma

Ref.	Study type	Cancer therapy	No of patients (Tx vs control)	Antiviral therapy	HBV reactivation (Tx vs control)	P value
Nagamatsu et al[10]	Retrospective	TAI	17 (8 vs 9)	LAM	0% vs 67%	0.009
Jang et al[17]	RCT	TACL	73 (36 vs 37)	LAM	2.8% vs 29.7%	0.002
Kim et al[6]	Retrospective	TACE + RT	48 (16 vs 32)	LAM	0% vs 21.8%	0.048
Huang et al[35]	Prospective	Hepatectomy	164 (126 vs 38)	LAM, ETV, ADV, TBVD	1.6% vs 21.1%	< 0.001
Dan et al[38]	Retrospective	Hepatectomy, RFA	218 (68 vs 150)	LAM, ETV, LAM + ADV	2.9% vs 20.7%1	0.027
					0% vs 7.6%2	NS
Huang et al[37]	RCT	Hepatectomy	84 (40 vs 44)	TBVD	2.5% vs 31.8%	0.001
Huang et al[16]	Retrospective	Hepatectomy	1609 (150 vs 1459)	LAM, ETV, ADV	4.7% vs 20.1%	< 0.001

¹Data following hepatectomy;

²Data following RFA. HBV: Hepatitis B virus; HCC: Hepatocellular carcinoma; Tx: Treatment; RCT: Randomized controlled trial; TAI: Transarterial infusion chemotherapy; TACL: Transarterial chemo-lipiodolization; TACE: Transarterial chemo-embolization; RT: Radiotherapy; LAM: Lamivudine; ETV: Entecavir; ADV: Adefovir; TBVD: Telbivudine; NS: Not significant.