Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment

A multicenter study

Baek Gyu Jun, Young Don Kim, Sang Gyune Kim, Young Seok Kim, Soung Won Jeong, Jae Young Jang, Sae Hwan Lee, Hong Soo Kim, Seong Hee Kang, Moonyoung Kim, Soonkoo Baik, Minjong Lee, Tae Suk Kim, Dae Hee Choi, Sang Hyeon Choi, Ki Tae Suk, Dong Joon Kim, Gab Jin Cheon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Convincing data that support routine use of preventive therapy against hepatitis B virus (HBV) reactivation in radiotherapy (RT) for hepatocellular carcinoma (HCC) are lacking. The aim of this study was to investigate the incidence, clinical significance, and risk factors of HBV reactivation after RT. Medical records of 133 HBsAg (+) HCC patients who received radiotherapy from March 2009 to February 2016 were reviewed. Patients were divided into two groups: 1) non-antiviral group, those who did not receive antiviral therapy before RT (n = 27); and antiviral group (those who underwent antiviral therapy before RT) (n = 106). Factors related to HBV reactivation in HCC patients were evaluated. 17 (12.7%) of 133 patients developed HBV reactivation after RT. Patients in the antiviral group had significantly lower rates of HBV reactivation than those in the non-antiviral group (7.5% vs. 33.3%, p<0.001). HBV related hepatitis was also lower in the antiviral group (3.8% vs. 14.8%, p = 0.031). In multivariate analysis, absence of antiviral treatment (OR: 8.339, 95% CI: 2.532–27.470, p<0.001) and combined treatment of RT with transarterial chemoembolizatoin (TACE) (OR: 5.313, 95% CI: 1.548–18.232, p = 0.008) were risk factors for HBV reactivation. HBV reactivation can occur after radiotherapy. Combination treatment of RT with TACE and non-antiviral treatment are major risk factors for HBV reactivation during or after RT. Therefore, preventive antiviral therapy should be recommended for patients with HCC who are scheduled to receive RT.

Original languageEnglish
Article numbere0201316
JournalPloS one
Volume13
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

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Hepatitis B virus
Radiotherapy
radiotherapy
hepatoma
Viruses
Multicenter Studies
Antiviral Agents
Hepatocellular Carcinoma
therapeutics
risk factors
Therapeutics
hepatitis
Hepatitis B Surface Antigens
Hepatitis
multivariate analysis
Medical Records
Multivariate Analysis
incidence

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Jun, Baek Gyu ; Kim, Young Don ; Kim, Sang Gyune ; Kim, Young Seok ; Jeong, Soung Won ; Jang, Jae Young ; Lee, Sae Hwan ; Kim, Hong Soo ; Kang, Seong Hee ; Kim, Moonyoung ; Baik, Soonkoo ; Lee, Minjong ; Kim, Tae Suk ; Choi, Dae Hee ; Choi, Sang Hyeon ; Suk, Ki Tae ; Kim, Dong Joon ; Cheon, Gab Jin. / Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment : A multicenter study. In: PloS one. 2018 ; Vol. 13, No. 7.
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title = "Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment: A multicenter study",
abstract = "Convincing data that support routine use of preventive therapy against hepatitis B virus (HBV) reactivation in radiotherapy (RT) for hepatocellular carcinoma (HCC) are lacking. The aim of this study was to investigate the incidence, clinical significance, and risk factors of HBV reactivation after RT. Medical records of 133 HBsAg (+) HCC patients who received radiotherapy from March 2009 to February 2016 were reviewed. Patients were divided into two groups: 1) non-antiviral group, those who did not receive antiviral therapy before RT (n = 27); and antiviral group (those who underwent antiviral therapy before RT) (n = 106). Factors related to HBV reactivation in HCC patients were evaluated. 17 (12.7{\%}) of 133 patients developed HBV reactivation after RT. Patients in the antiviral group had significantly lower rates of HBV reactivation than those in the non-antiviral group (7.5{\%} vs. 33.3{\%}, p<0.001). HBV related hepatitis was also lower in the antiviral group (3.8{\%} vs. 14.8{\%}, p = 0.031). In multivariate analysis, absence of antiviral treatment (OR: 8.339, 95{\%} CI: 2.532–27.470, p<0.001) and combined treatment of RT with transarterial chemoembolizatoin (TACE) (OR: 5.313, 95{\%} CI: 1.548–18.232, p = 0.008) were risk factors for HBV reactivation. HBV reactivation can occur after radiotherapy. Combination treatment of RT with TACE and non-antiviral treatment are major risk factors for HBV reactivation during or after RT. Therefore, preventive antiviral therapy should be recommended for patients with HCC who are scheduled to receive RT.",
author = "Jun, {Baek Gyu} and Kim, {Young Don} and Kim, {Sang Gyune} and Kim, {Young Seok} and Jeong, {Soung Won} and Jang, {Jae Young} and Lee, {Sae Hwan} and Kim, {Hong Soo} and Kang, {Seong Hee} and Moonyoung Kim and Soonkoo Baik and Minjong Lee and Kim, {Tae Suk} and Choi, {Dae Hee} and Choi, {Sang Hyeon} and Suk, {Ki Tae} and Kim, {Dong Joon} and Cheon, {Gab Jin}",
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Jun, BG, Kim, YD, Kim, SG, Kim, YS, Jeong, SW, Jang, JY, Lee, SH, Kim, HS, Kang, SH, Kim, M, Baik, S, Lee, M, Kim, TS, Choi, DH, Choi, SH, Suk, KT, Kim, DJ & Cheon, GJ 2018, 'Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment: A multicenter study', PloS one, vol. 13, no. 7, e0201316. https://doi.org/10.1371/journal.pone.0201316

Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment : A multicenter study. / Jun, Baek Gyu; Kim, Young Don; Kim, Sang Gyune; Kim, Young Seok; Jeong, Soung Won; Jang, Jae Young; Lee, Sae Hwan; Kim, Hong Soo; Kang, Seong Hee; Kim, Moonyoung; Baik, Soonkoo; Lee, Minjong; Kim, Tae Suk; Choi, Dae Hee; Choi, Sang Hyeon; Suk, Ki Tae; Kim, Dong Joon; Cheon, Gab Jin.

In: PloS one, Vol. 13, No. 7, e0201316, 01.07.2018.

Research output: Contribution to journalArticle

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T1 - Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment

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AU - Jun, Baek Gyu

AU - Kim, Young Don

AU - Kim, Sang Gyune

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AU - Jeong, Soung Won

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AU - Lee, Sae Hwan

AU - Kim, Hong Soo

AU - Kang, Seong Hee

AU - Kim, Moonyoung

AU - Baik, Soonkoo

AU - Lee, Minjong

AU - Kim, Tae Suk

AU - Choi, Dae Hee

AU - Choi, Sang Hyeon

AU - Suk, Ki Tae

AU - Kim, Dong Joon

AU - Cheon, Gab Jin

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N2 - Convincing data that support routine use of preventive therapy against hepatitis B virus (HBV) reactivation in radiotherapy (RT) for hepatocellular carcinoma (HCC) are lacking. The aim of this study was to investigate the incidence, clinical significance, and risk factors of HBV reactivation after RT. Medical records of 133 HBsAg (+) HCC patients who received radiotherapy from March 2009 to February 2016 were reviewed. Patients were divided into two groups: 1) non-antiviral group, those who did not receive antiviral therapy before RT (n = 27); and antiviral group (those who underwent antiviral therapy before RT) (n = 106). Factors related to HBV reactivation in HCC patients were evaluated. 17 (12.7%) of 133 patients developed HBV reactivation after RT. Patients in the antiviral group had significantly lower rates of HBV reactivation than those in the non-antiviral group (7.5% vs. 33.3%, p<0.001). HBV related hepatitis was also lower in the antiviral group (3.8% vs. 14.8%, p = 0.031). In multivariate analysis, absence of antiviral treatment (OR: 8.339, 95% CI: 2.532–27.470, p<0.001) and combined treatment of RT with transarterial chemoembolizatoin (TACE) (OR: 5.313, 95% CI: 1.548–18.232, p = 0.008) were risk factors for HBV reactivation. HBV reactivation can occur after radiotherapy. Combination treatment of RT with TACE and non-antiviral treatment are major risk factors for HBV reactivation during or after RT. Therefore, preventive antiviral therapy should be recommended for patients with HCC who are scheduled to receive RT.

AB - Convincing data that support routine use of preventive therapy against hepatitis B virus (HBV) reactivation in radiotherapy (RT) for hepatocellular carcinoma (HCC) are lacking. The aim of this study was to investigate the incidence, clinical significance, and risk factors of HBV reactivation after RT. Medical records of 133 HBsAg (+) HCC patients who received radiotherapy from March 2009 to February 2016 were reviewed. Patients were divided into two groups: 1) non-antiviral group, those who did not receive antiviral therapy before RT (n = 27); and antiviral group (those who underwent antiviral therapy before RT) (n = 106). Factors related to HBV reactivation in HCC patients were evaluated. 17 (12.7%) of 133 patients developed HBV reactivation after RT. Patients in the antiviral group had significantly lower rates of HBV reactivation than those in the non-antiviral group (7.5% vs. 33.3%, p<0.001). HBV related hepatitis was also lower in the antiviral group (3.8% vs. 14.8%, p = 0.031). In multivariate analysis, absence of antiviral treatment (OR: 8.339, 95% CI: 2.532–27.470, p<0.001) and combined treatment of RT with transarterial chemoembolizatoin (TACE) (OR: 5.313, 95% CI: 1.548–18.232, p = 0.008) were risk factors for HBV reactivation. HBV reactivation can occur after radiotherapy. Combination treatment of RT with TACE and non-antiviral treatment are major risk factors for HBV reactivation during or after RT. Therefore, preventive antiviral therapy should be recommended for patients with HCC who are scheduled to receive RT.

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