Open AccessPotential risk factors for the reactivation of the replication of hepatitis B and C viruses after transcatheter arterial chemoembolization of hepatocellular carcinoma
Author(s) -
Lin ChiaI.,
Lin ZuYau,
Hsieh MingYen,
Huang ChungFeng,
Chen SuHwei,
Chuang WanLong
Publication year - 2011
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/j.kjms.2011.06.029
Subject(s) - medicine , hepatocellular carcinoma , transcatheter arterial chemoembolization , white blood cell , mitomycin c , gastroenterology , hepatitis c virus , hepatitis b virus , viral load , virus , virology , surgery
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.