Yang Yu, Du Yang, Luo Wu-Xia, Li Cong, Chen Ye, Cheng Ke, Ding Jing, Zhou Yi, Ge Jun, Yang Xian, Liu Ji-Yan
Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China.
Cancer Chemother Pharmacol. 2015 Apr;75(4):783-90. doi: 10.1007/s00280-015-2700-4. Epub 2015 Feb 17.
The objectives of this study were to investigate the incidences of hepatitis B virus (HBV) reactivation and hepatitis in gastrointestinal cancer patients with positive hepatitis B surface antigen (HBsAg) after chemotherapy and assess the effect of antiviral therapy on preventing HBV reactivation and hepatitis.
The medical records of gastric or colorectal cancer patients with positive HBsAg undergoing chemotherapy in West China Hospital were reviewed from January 2009 to August 2014.
One hundred and fifty-six patients were included. Seventy-six patients had no records of the baseline HBV DNA copy (bHDC) and received no antiviral therapy. Of 80 patients with known bHDCs, 39 patients received antiviral therapy. The incidence of HBV reactivation was 14.6% in the non-antiviral group with known bHDCs (n = 41), compared with 0% in the antiviral group (P = 0.039). Compared with 12.8% in the antiviral group (P = 0.034), 29.9% of patients suffered from hepatitis in the total non-antiviral group (n = 117). More patients with moderate/severe hepatitis were seen in the non-antiviral group (P = 0.027). Non-antiviral therapy was the only risk factor for hepatitis in multivariate analysis (HR 3.195, 95% CI 1.117-10.989; P = 0.043).
HBV reactivation and hepatitis occurred in a significant proportion of gastrointestinal cancer patients with positive HBsAg who received chemotherapy. Antiviral therapy could reduce the incidences of HBV reactivation and hepatitis.
本研究旨在调查化疗后乙肝表面抗原（HBsAg）阳性的胃肠道癌症患者中乙肝病毒（HBV）再激活和肝炎的发生率，并评估抗病毒治疗对预防HBV再激活和肝炎的效果。
回顾性分析2009年1月至2014年8月在华西医院接受化疗的HBsAg阳性胃癌或结直肠癌患者的病历。
共纳入156例患者。76例患者无基线HBV DNA拷贝数（bHDC）记录且未接受抗病毒治疗。在80例已知bHDC的患者中，39例接受了抗病毒治疗。已知bHDC的非抗病毒组（n = 41）中HBV再激活的发生率为14.6%，而抗病毒组为0%（P = 0.039）。与抗病毒组的12.8%相比（P = 0.034），总非抗病毒组（n = 117）中有29.9%的患者发生肝炎。非抗病毒组中中度/重度肝炎患者更多（P = 0.027）。多因素分析显示，非抗病毒治疗是肝炎的唯一危险因素（HR 3.195，95%CI 1.117 - 10.989；P = 0.043）。
接受化疗的HBsAg阳性胃肠道癌症患者中，相当一部分发生了HBV再激活和肝炎。抗病毒治疗可降低HBV再激活和肝炎的发生率。
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