Hepatocellular Carcinoma Is Associated With an Increased Risk of Hepatitis B Virus Recurrence After Liver Transplantation

Faria, Luciana Costa; Gigou, Michelle; Roque-Afonso, A.M.; Sebagh, Mylène; Roche, Bruno; Fallot, Guillaume; Ferrari, Teresa Cristina Abreu; Guettier, Catherine; Dussaix, Élisabeth; Castaing, Denis; Bréchot, Christian; Samuel, Didier

doi:10.1053/j.gastro.2008.02.064

Cited by 163 publications

(152 citation statements)

References 37 publications

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“…Still, rudimental HBV from extrahepatic reservoirs remains, which is the source of HBV recurrence [13]. Covalently closed circular DNA has been detected integrating into the tumor cells from the explanted liver, as well as extrahepatic HCC metastasis [14]. Distant recurrence is speculated to be caused by metastatic cells which go undetected before surgery and circulate before taking up residence in the graft [15].…”

Section: Discussionmentioning

confidence: 99%

High Hepatitis B Virus DNA Level in Serum before Liver Transplantation Increases the Risk of Hepatocellular Carcinoma Recurrence

Chen²,

Cai³

et al. 2011

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Aim: To analyze the relationship between hepatitis B virus (HBV) and hepatocellular carcinoma (HCC) recurrence in orthotopic liver transplantation (OLT) patients. Methods: 340 HBV patients with OLT were included in the study; among them were 148 patients with HBV-associated HCC. Results: HCC recurrence rates at 1, 3 and 5 years were 21, 29, and 46%, respectively. Exceeding Milan criteria (hazard ratio, HR = 12.35; 95% confidence interval, CI, 2.80–54.49; p = 0.001), HBV DNA level >5 log₁₀ copies/ml before transplant (HR = 2.45; 95% CI 1.10–5.45; p = 0.03) and HBV recurrence (HR = 2.27; 95% CI 1.10–4.75; p = 0.03) were significant independent predictors of HCC recurrence. HBV DNA >5 log₁₀ copies/ml before transplant (HR = 8.65; 95% CI 3.40–21.98; p < 0.001) and concomitance with HCC (HR = 2.79; 95% CI 1.33–5.87; p = 0.007) were predictors of HBV recurrence. Further stratified analysis showed that HBV recurrence was more prevalent in the HCC recurrence group (HR = 4.58; 95% CI 1.88–11.12; p = 0.001). Conclusions: There is a close relationship between HBV and HCC recurrence after transplant. High HBV DNA levels before transplant are associated with HCC recurrence after transplant.

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Section: Discussionmentioning

confidence: 99%

High Hepatitis B Virus DNA Level in Serum before Liver Transplantation Increases the Risk of Hepatocellular Carcinoma Recurrence

Chen²,

Cai³

et al. 2011

Digestion

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“…The level of viral replication before transplantation is a wellestablished predictor for prophylaxis success, regardless of the prophylactic protocol (7,8,(18)(19)(20) (9,21), while others found no association between HCC prior to OLT and posttransplant recurrent hepatitis B (7,18,22,23 …”

Section: In This Retrospective Review Of 209 Hbsag-positive Patientsmentioning

confidence: 99%

High Viremia, Prolonged Lamivudine Therapy and Recurrent Hepatocellular Carcinoma Predict Posttransplant Hepatitis B Recurrence

Chun

Kim

et al. 2010

American Journal of Transplantation

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“…Previous studies have shown a temporal relationship between the development of posttransplant HCC recurrence and the re-appearance of HBsAg and HBV DNA [77] . This suggests an association rather than viral factors being a causative factor for recurrence.…”

Section: Antiviral Therapy For Hcc Patients Undergoing Liver Transplamentioning

confidence: 97%

The role of oral antiviral therapy in hepatitis B-related hepatocellular carcinoma

Fung¹,

Chok²

2017

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Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) in places where chronic hepatitis B infection is endemic. Oral nucleos(t)ide analog (NA) therapy can reduce the risk of HCC, but cannot completely prevent its development. For HBV-related HCCs, viral inhibition by NAs can preserve or improve liver function, thereby increasing the chance of therapeutic intervention. After surgical resection, NAs can prevent reactivation of HBV, and also reduce the chance of de novo development of HCC in the remnant liver. For those who undergo liver transplantation, NAs are essential to prevent reactivation and graft hepatitis, but is not likely to prevent HCC recurrence, which is due to metastatic disease. The role of NAs for non-curable advanced HCC is less well defined. These include patients undergoing locoregional therapy, chemotherapy, or palliation. Although antiviral therapy can preserve liver function, which may be compromised by HBV, it is unable to prevent disease progression from HCC. At the time of HCC diagnosis, most patients will already be receiving NAs, and these patients should be maintained on therapy. For patients not on antiviral therapy at the time of HCC diagnosis, the decision to commence therapy is often determined by the stage of HCC and life expectancy. Patients undergoing curative therapy, or locoregional therapy/chemotherapy with reasonable life expectancy, should be commenced on antiviral therapy. Key words:Antiviral therapy, hepatitis B virus, hepatocellular carcinoma ABSTRACTArticle history:

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Hepatocellular Carcinoma Is Associated With an Increased Risk of Hepatitis B Virus Recurrence After Liver Transplantation

Cited by 163 publications

References 37 publications

High Hepatitis B Virus DNA Level in Serum before Liver Transplantation Increases the Risk of Hepatocellular Carcinoma Recurrence

High Hepatitis B Virus DNA Level in Serum before Liver Transplantation Increases the Risk of Hepatocellular Carcinoma Recurrence

High Viremia, Prolonged Lamivudine Therapy and Recurrent Hepatocellular Carcinoma Predict Posttransplant Hepatitis B Recurrence

The role of oral antiviral therapy in hepatitis B-related hepatocellular carcinoma

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