Skip to main content

Advertisement

Log in

Changes of HBV DNA After Chemoembolization for Hepatocellular Carcinoma and the Efficacy of Antiviral Treatment

  • Review
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Unlike systemic chemotherapy for hematological malignancies with hepatitis B virus (HBV) infection, transarterial chemoembolization (TACE) for HBV-related hepatocellular carcinoma (HCC) has only recently been reported to cause HBV reactivation and subsequent hepatitis. Most patients with HBV-related HCC have an underlying disease with liver fibrosis or cirrhosis, and TACE may potentially induce HBV reactivation and liver decompensation. Currently, there are no clinical guidelines for managing TACE-caused HBV reactivation. In this review, we summarize the changes of HBV status and liver function after TACE and the effect of antiviral treatment before, during, or after TACE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917.

    Article  CAS  PubMed  Google Scholar 

  2. Wei KR, Yu X, Zheng RS, et al. Incidence and mortality of liver cancer in China, 2010. Chin J Cancer. 2014;33:388–394.

    PubMed  PubMed Central  Google Scholar 

  3. Beasley RP, Hwang LY, Lin CC, et al. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22 707 men in Taiwan. Lancet. 1981;2:1129–1133.

    Article  CAS  PubMed  Google Scholar 

  4. Chen CF, Lee WC, Yang HI, et al. Changes in serum levels of HBV DNA and alanine aminotransferase determine risk for hepatocellular carcinoma. Gastroenterology. 2011;141:1240–1248. (1248 e1241–1248 e1242).

    Article  CAS  PubMed  Google Scholar 

  5. Tsukuma H, Hiyama T, Tanaka S, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med. 1993;328:1797–1801.

    Article  CAS  PubMed  Google Scholar 

  6. Lai EC, Fan ST, Lo CM, et al. Hepatic resection for hepatocellular carcinoma. An audit of 343 patients. Ann Surg. 1995;221:291–298.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Llovet JM, Real MI, Montana X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359:1734–1739.

    Article  PubMed  Google Scholar 

  8. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37:429–442.

    Article  CAS  PubMed  Google Scholar 

  9. Lee HS, Kim KM, Yoon JH, et al. Therapeutic efficacy of transcatheter arterial chemoembolization as compared with hepatic resection in hepatocellular carcinoma patients with compensated liver function in a hepatitis B virus-endemic area: a prospective cohort study. J Clin Oncol. 2002;20:4459–4465.

    Article  PubMed  Google Scholar 

  10. Lo CM, Ngan H, Tso WK, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002;35:1164–1171.

    Article  CAS  PubMed  Google Scholar 

  11. Li M, Lu C, Cheng J, et al. Combination therapy with transarterial chemoembolization and interferon-alpha compared with transarterial chemoembolization alone for hepatitis B virus related unresectable hepatocellular carcinoma. J Gastroenterol Hepatol. 2009;24:1437–1444.

    Article  CAS  PubMed  Google Scholar 

  12. Shi M, Lu LG, Fang WQ, et al. Roles played by chemolipiodolization and embolization in chemoembolization for hepatocellular carcinoma: single-blind, randomized trial. J Natl Cancer Inst. 2013;105:59–68.

    Article  CAS  PubMed  Google Scholar 

  13. Kruskal JB, Hlatky L, Hahnfeldt P, et al. In vivo and in vitro analysis of the effectiveness of doxorubicin combined with temporary arterial occlusion in liver tumors. J Vasc Interv Radiol. 1993;4:741–747.

    Article  CAS  PubMed  Google Scholar 

  14. Yuen MF. Need to improve awareness and management of hepatitis B reactivation in patients receiving immunosuppressive therapy. Hepatol Int. 2016;10:102–105.

    Article  PubMed  Google Scholar 

  15. Lau GK, Leung YH, Fong DY, et al. High hepatitis B virus (HBV) DNA viral load as the most important risk factor for HBV reactivation in patients positive for HBV surface antigen undergoing autologous hematopoietic cell transplantation. Blood. 2002;99:2324–2330.

    Article  CAS  PubMed  Google Scholar 

  16. Yeo W, Chan PK, Chan HL, et al. Hepatitis B virus reactivation during cytotoxic chemotherapy-enhanced viral replication precedes overt hepatitis. J Med Virol. 2001;65:473–477.

    Article  CAS  PubMed  Google Scholar 

  17. Mindikoglu AL, Regev A, Schiff ER. Hepatitis B virus reactivation after cytotoxic chemotherapy: the disease and its prevention. Clin Gastroenterol Hepatol. 2006;4:1076–1081.

    Article  CAS  PubMed  Google Scholar 

  18. Lok AS, Liang RH, Chiu EK, et al. Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy. Report of a prospective study. Gastroenterology. 1991;100:182–188.

    Article  CAS  PubMed  Google Scholar 

  19. Bruix J, Llovet JM. Hepatitis B virus and hepatocellular carcinoma. J Hepatol. 2003;39:S59–S63.

    Article  PubMed  Google Scholar 

  20. Jang JW. Hepatitis B virus reactivation in patients with hepatocellular carcinoma undergoing anti-cancer therapy. World J Gastroenterol. 2014;20:7675–7685.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology. 2016;150:835–853.

    Article  PubMed  Google Scholar 

  22. Yeo W, Mok TS, Zee B, et al. A randomized phase III study of doxorubicin versus cisplatin/interferon alpha-2b/doxorubicin/fluorouracil (PIAF) combination chemotherapy for unresectable hepatocellular carcinoma. J Natl Cancer Inst. 2005;97:1532–1538.

    Article  CAS  PubMed  Google Scholar 

  23. Yeo W, Lam KC, Zee B, et al. Hepatitis B reactivation in patients with hepatocellular carcinoma undergoing systemic chemotherapy. Ann Oncol. 2004;15:1661–1666.

    Article  CAS  PubMed  Google Scholar 

  24. Lalazar G, Rund D, Shouval D. Screening, prevention and treatment of viral hepatitis B reactivation in patients with haematological malignancies. Br J Haematol. 2007;136:699–712.

    Article  CAS  PubMed  Google Scholar 

  25. Vogl TJ, Naguib NN, Nour-Eldin NE, et al. Review on transarterial chemoembolization in hepatocellular carcinoma: palliative, combined, neoadjuvant, bridging, and symptomatic indications. Eur J Radiol. 2009;72:505–516.

    Article  PubMed  Google Scholar 

  26. Omata M, Lesmana LA, Tateishi R, et al. Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol Int.. 2010;4:439–474.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Giunchedi P, Maestri M, Gavini E, et al. Transarterial chemoembolization of hepatocellular carcinoma. Agents and drugs: an overview. Part 1. Expert Opin Drug Deliv. 2013;10:679–690.

    Article  CAS  PubMed  Google Scholar 

  28. Lewandowski RJ, Geschwind JF, Liapi E, et al. Transcatheter intraarterial therapies: rationale and overview. Radiology. 2011;259:641–657.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Tur-Kaspa R, Burk RD, Shaul Y, et al. Hepatitis B virus DNA contains a glucocorticoid-responsive element. Proc Natl Acad Sci USA. 1986;83:1627–1631.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Cheng AL, Hsiung CA, Su IJ, et al. Steroid-free chemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma. Hepatology. 2003;37:1320–1328.

    Article  CAS  PubMed  Google Scholar 

  31. Cheung KS, Seto WK, Lai CL, et al. Prevention and management of hepatitis B virus reactivation in cancer patients. Hepatol Int. 2016;10:407–414.

    Article  PubMed  Google Scholar 

  32. Evens AM, Jovanovic BD, Su YC, et al. Rituximab-associated hepatitis B virus (HBV) reactivation in lymphoproliferative diseases: meta-analysis and examination of FDA safety reports. Ann Oncol. 2011;22:1170–1180.

    Article  CAS  PubMed  Google Scholar 

  33. Yeo W, Johnson PJ. Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy. Hepatology. 2006;43:209–220.

    Article  CAS  PubMed  Google Scholar 

  34. Idee JM, Guiu B. Use of Lipiodol as a drug-delivery system for transcatheter arterial chemoembolization of hepatocellular carcinoma: a review. Crit Rev Oncol Hematol. 2013;88:530–549.

    Article  PubMed  Google Scholar 

  35. Raoul JL, Heresbach D, Bretagne JF, et al. Chemoembolization of hepatocellular carcinomas. A study of the biodistribution and pharmacokinetics of doxorubicin. Cancer. 1992;70:585–590.

    Article  CAS  PubMed  Google Scholar 

  36. Ikoma A, Kawai N, Sato M, et al. Comparison of blood dynamics of anticancer drugs (cisplatin, mitomycin C, epirubicin) in treatment groups of hepatic arterial infusion, hepatic arterial infusion with lipiodol and transcatheter arterial chemoembolization with lipiodol plus gelatin sponge particles in a swine model. Hepatol Res. 2012;42:1227–1235.

    Article  CAS  PubMed  Google Scholar 

  37. Varela M, Real MI, Burrel M, et al. Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol. 2007;46:474–481.

    Article  CAS  PubMed  Google Scholar 

  38. Hsieh MY, Lin ZY, Chen SH, et al. Risk factors for the leakage of chemotherapeutic agents into systemic circulation after transcatheter arterial chemoembolization of hepatocellular carcinoma. Kaohsiung J Med Sci. 2011;27:431–436.

    Article  CAS  PubMed  Google Scholar 

  39. European Association for The Study of the L. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol. 2012;57:167–185.

    Article  Google Scholar 

  40. Wands JR, Chura CM, Roll FJ, et al. Serial studies of hepatitis-associated antigen and antibody in patients receiving antitumor chemotherapy for myeloproliferative and lymphoproliferative disorders. Gastroenterology. 1975;68:105–112.

    CAS  PubMed  Google Scholar 

  41. Vizzini GB, Luca A, Marino IR. Hepatitis B virus reactivation after a single session of transarterial chemoembolization in patients with hepatocellular carcinoma. Ann Intern Med. 2003;138:691–692.

    Article  PubMed  Google Scholar 

  42. Hung HH, Su CW, Wu JC, et al. Reactivation of hepatitis B virus after transarterial chemo-embolization for hepatocellular carcinoma in one patient with negative hepatitis B surface antigen. J Hepatol. 2010;52:463–465.

    Article  PubMed  Google Scholar 

  43. Tamori A, Nishiguchi S, Tanaka M, et al. Lamivudine therapy for hepatitis B virus reactivation in a patient receiving intra-arterial chemotherapy for advanced hepatocellular carcinoma. Hepatol Res. 2003;26:77–80.

    Article  PubMed  Google Scholar 

  44. Jang JW, Kwon JH, You CR, et al. Risk of HBV reactivation according to viral status and treatment intensity in patients with hepatocellular carcinoma. Antivir Ther. 2011;16:969–977.

    Article  CAS  PubMed  Google Scholar 

  45. Hsu CH, Hsu HC, Chen HL, et al. Doxorubicin activates hepatitis B virus (HBV) replication in HBV-harboring hepatoblastoma cells. A possible novel mechanism of HBV reactivation in HBV carriers receiving systemic chemotherapy. Anticancer Res. 2004;24:3035–3040.

    CAS  PubMed  Google Scholar 

  46. Xu L, Tu Z, Xu G, et al. Epirubicin directly promotes hepatitis B virus (HBV) replication in stable HBV-expressing cell lines: a novel mechanism of HBV reactivation following anticancer chemotherapy. Mol Med Rep. 2014;9:1345–1350.

    CAS  PubMed  Google Scholar 

  47. Chen YF, Chong CL, Wu YC, et al. Doxorubicin activates hepatitis B virus replication by elevation of p21 (Waf1/Cip1) and C/EBPalpha expression. PLoS One. 2015;10:e0131743.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Jang JW, Choi JY, Bae SH, et al. Transarterial chemo-lipiodolization can reactivate hepatitis B virus replication in patients with hepatocellular carcinoma. J Hepatol. 2004;41:427–435.

    Article  CAS  PubMed  Google Scholar 

  49. Jang JW, Choi JY, Bae SH, et al. A randomized controlled study of preemptive lamivudine in patients receiving transarterial chemo-lipiodolization. Hepatology. 2006;43:233–240.

    Article  CAS  PubMed  Google Scholar 

  50. Shao W, Zhang F, Cong N, et al. The hepatitis B virus reactivation after transarterial chemoembolization in Chinese hepatocellular carcinoma patients with low serum hepatitis B virus DNA level. Ther Clin Risk Manag. 2015;11:1367–1370.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Lao XM, Luo G, Ye LT, et al. Effects of antiviral therapy on hepatitis B virus reactivation and liver function after resection or chemoembolization for hepatocellular carcinoma. Liver Int. 2013;33:595–604.

    Article  CAS  PubMed  Google Scholar 

  52. Lao XM, Wang D, Shi M, et al. Changes in hepatitis B virus DNA levels and liver function after transcatheter arterial chemoembolization of hepatocellular carcinoma. Hepatol Res. 2011;41:553–563.

    Article  CAS  PubMed  Google Scholar 

  53. Lin CI, Lin ZY, Hsieh MY, et al. Potential risk factors for the reactivation of the replication of hepatitis B and C viruses after transcatheter arterial chemoembolization of hepatocellular carcinoma. Kaohsiung J Med Sci. 2011;27:554–559.

    Article  PubMed  Google Scholar 

  54. Marzano A, Angelucci E, Andreone P, et al. Prophylaxis and treatment of hepatitis B in immunocompromised patients. Dig Liver Dis. 2007;39:397–408.

    Article  CAS  PubMed  Google Scholar 

  55. Cornberg M, Protzer U, Petersen J, et al. Prophylaxis, diagnosis and therapy of hepatitis B virus infection—the German guideline. Z Gastroenterol. 2011;49:871–930.

    Article  CAS  PubMed  Google Scholar 

  56. Peng JW, Lin GN, Xiao JJ, et al. Hepatitis B virus reactivation in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization therapy. Asia Pac J Clin Oncol. 2012;8:356–361.

    Article  PubMed  Google Scholar 

  57. Jang JW, Kim YW, Lee SW, et al. Reactivation of hepatitis B virus in HBsAg-negative patients with hepatocellular carcinoma. PLoS One. 2015;10:e0122041.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Ling WH, Soe PP, Pang AS, et al. Hepatitis B virus reactivation risk varies with different chemotherapy regimens commonly used in solid tumours. Br J Cancer. 2013;108:1931–1935.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Park JW, Park KW, Cho SH, et al. Risk of hepatitis B exacerbation is low after transcatheter arterial chemoembolization therapy for patients with HBV-related hepatocellular carcinoma: report of a prospective study. Am J Gastroenterol. 2005;100:2194–2200.

    Article  PubMed  Google Scholar 

  60. Nagamatsu H, Kumashiro R, Itano S, et al. Investigation of associating factors in exacerbation of liver damage after chemotherapy in patients with HBV-related HCC. Hepatol Res. 2003;26:293–301.

    Article  PubMed  Google Scholar 

  61. Xu J, Wang YH, Xia JL, et al. Effect of transcatheter arterial chemoembolization on HBV DNA level in primary liver cancer patients. Chin J Cancer. 2009;28:520–523.

    Google Scholar 

  62. Xu X, Huang P, Tian H, et al. Role of lamivudine with transarterial chemoembolization in the survival of patients with hepatocellular carcinoma. J Gastroenterol Hepatol. 2014;29:1273–1278.

    Article  CAS  PubMed  Google Scholar 

  63. Wu IC, Chow NH, Cheng PN, et al. Characterization of viral kinetics in patients with hepatitis B e antigen-positive chronic hepatitis B. J Med Virol. 2007;79:663–669.

    Article  PubMed  Google Scholar 

  64. Huo TI, Wu JC, Lee PC, et al. Incidence and risk factors for acute renal failure in patients with hepatocellular carcinoma undergoing transarterial chemoembolization: a prospective study. Liver Int. 2004;24:210–215.

    Article  PubMed  Google Scholar 

  65. Huo TI, Lee SD, Wu JC. Hepatitis after arterial embolization for hepatocellular carcinoma: viral reactivation or ischemia? Hepatology. 2006;43:1400–1401.

    Article  PubMed  Google Scholar 

  66. Chen CJ, Yang HI, Su J, et al. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 2006;295:65–73.

    Article  CAS  PubMed  Google Scholar 

  67. Shao YY, Chen PJ, Lin ZZ, et al. Impact of baseline hepatitis B viral DNA levels on survival of patients with advanced hepatocellular carcinoma. Anticancer Res. 2011;31:4007–4011.

    CAS  PubMed  Google Scholar 

  68. Jang JW, Choi JY, Bae SH, et al. The impact of hepatitis B viral load on recurrence after complete necrosis in patients with hepatocellular carcinoma who receive transarterial chemolipiodolization: implications for viral suppression to reduce the risk of cancer recurrence. Cancer. 2007;110:1760–1767.

    Article  PubMed  Google Scholar 

  69. Yang T, Lu JH, Zhai J, et al. High viral load is associated with poor overall and recurrence-free survival of hepatitis B virus-related hepatocellular carcinoma after curative resection: a prospective cohort study. Eur J Surg Oncol. 2012;38:683–691.

    Article  CAS  PubMed  Google Scholar 

  70. Wong GL. How does hepatitis B virus infection react to hepatocellular carcinoma treatment? J Gastroenterol Hepatol. 2012;27:1–2.

    Article  CAS  PubMed  Google Scholar 

  71. Wang CC, Kao JH. How have the recent advances in antiviral therapy impacted the management of virus-related hepatocellular carcinoma? Expert Opin Pharmacother. 2016. doi:10.1517/14656566.2016.1149165.

    Google Scholar 

  72. Huang G, Lau WY, Wang ZG, et al. Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma: a randomized controlled trial. Ann Surg. 2015;261:56–66.

    Article  PubMed  Google Scholar 

  73. Yin J, Li N, Han Y, et al. Effect of antiviral treatment with nucleotide/nucleoside analogs on postoperative prognosis of hepatitis B virus-related hepatocellular carcinoma: a two-stage longitudinal clinical study. J Clin Oncol. 2013;31:3647–3655.

    Article  CAS  PubMed  Google Scholar 

  74. Wu CY, Chen YJ, Ho HJ, et al. Association between nucleoside analogues and risk of hepatitis B virus-related hepatocellular carcinoma recurrence following liver resection. JAMA. 2012;308:1906–1914.

    Article  CAS  PubMed  Google Scholar 

  75. Wong JS, Wong GL, Tsoi KK, et al. Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma. Aliment Pharmacol Ther. 2011;33:1104–1112.

    Article  PubMed  Google Scholar 

  76. Chong CC, Wong GL, Lai PB. Impact of antiviral therapy on post-hepatectomy outcome for hepatitis B-related hepatocellular carcinoma. World J Gastroenterol. 2014;20:6006–6012.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Chen JL, Lin XJ, Zhou Q, et al. Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection. Chin J Cancer. 2016;35:28.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Kim JH, Park JW, Koh DW, et al. Efficacy of lamivudine on hepatitis B viral status and liver function in patients with hepatitis B virus-related hepatocellular carcinoma. Liver Int. 2009;29:203–207.

    Article  CAS  PubMed  Google Scholar 

  79. Jin YJ, Shim JH, Lee HC, et al. Suppressive effects of entecavir on hepatitis B virus and hepatocellular carcinoma. J Gastroenterol Hepatol. 2011;26:1380–1388.

    Article  CAS  PubMed  Google Scholar 

  80. Nagamatsu H, Itano S, Nagaoka S, et al. Prophylactic lamivudine administration prevents exacerbation of liver damage in HBe antigen positive patients with hepatocellular carcinoma undergoing transhepatic arterial infusion chemotherapy. Am J Gastroenterol. 2004;99:2369–2375.

    Article  CAS  PubMed  Google Scholar 

  81. Li X, Zhong X, Chen ZH, et al. Efficacy of prophylactic entecavir for hepatitis B virus-related hepatocellular carcinoma receiving transcatheter arterial chemoembolization. Asian Pac J Cancer Prev. 2015;16:8665–8670.

    Article  PubMed  Google Scholar 

  82. Qu LS, Jin F, Huang XW, et al. High hepatitis B viral load predicts recurrence of small hepatocellular carcinoma after curative resection. J Gastrointest Surg. 2010;14:1111–1120.

    Article  PubMed  Google Scholar 

  83. Qu LS, Liu JX, Kuai XL, et al. Significance of viral status on recurrence of hepatitis B-related hepatocellular carcinoma after curative therapy: a meta-analysis. Hepatol Res. 2014;44:750–760.

    Article  PubMed  Google Scholar 

  84. Hung IF, Poon RT, Lai CL, et al. Recurrence of hepatitis B-related hepatocellular carcinoma is associated with high viral load at the time of resection. Am J Gastroenterol. 2008;103:1663–1673.

    Article  PubMed  Google Scholar 

  85. Chong CC, Wong GL, Wong VW, et al. Antiviral therapy improves post-hepatectomy survival in patients with hepatitis B virus-related hepatocellular carcinoma: a prospective-retrospective study. Aliment Pharmacol Ther. 2015;41:199–208.

    Article  CAS  PubMed  Google Scholar 

  86. Zhou Y, Zhang Z, Zhao Y, et al. Antiviral therapy decreases recurrence of hepatitis B virus-related hepatocellular carcinoma after curative resection: a meta-analysis. World J Surg. 2014;38:2395–2402.

    Article  PubMed  Google Scholar 

  87. Yu SJ, Lee JH, Jang ES, et al. Hepatocellular carcinoma: high hepatitis B viral load and mortality in patients treated with transarterial chemoembolization. Radiology. 2013;267:638–647.

    Article  PubMed  Google Scholar 

  88. Yu SJ, Kim YJ. Hepatitis B viral load affects prognosis of hepatocellular carcinoma. World J Gastroenterol. 2014;20:12039–12044.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Zhong JH. Nucleos(t)ide analogue therapy for HBV-related HCC after hepatic resection: clinical benefits and unanswered questions. Tumour Biol. 2014;35:12779–12784.

    Article  PubMed  Google Scholar 

  90. Zhou ZG, Zheng XR, Zhou Q, et al. Impact of oral anti-hepatitis B therapy on the survival of patients with hepatocellular carcinoma initially treated with chemoembolization. Chin J Cancer. 2015;34:205–216.

    CAS  PubMed  Google Scholar 

  91. Chan AC, Chok KS, Yuen WK, et al. Impact of antiviral therapy on the survival of patients after major hepatectomy for hepatitis B virus-related hepatocellular carcinoma. Arch Surg. 2011;146:675–681.

    Article  PubMed  Google Scholar 

  92. Toyoda H, Kumada T, Tada T, et al. Transarterial chemoembolization for hepatitis B virus-associated hepatocellular carcinoma: improved survival after concomitant treatment with nucleoside analogues. J Vasc Interv Radiol. 2012;23:e311.

    Google Scholar 

  93. Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2016;10:1–98.

    Article  CAS  PubMed  Google Scholar 

  94. Liaw YF, Kao JH, Piratvisuth T, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int. 2012;6:531–561.

    Article  PubMed  Google Scholar 

  95. Shin HS, Kim SU, Park JY, et al. Antiviral efficacy of lamivudine versus entecavir in patients with hepatitis B virus-related advanced hepatocellular carcinoma. J Gastroenterol Hepatol. 2012;27:1528–1534.

    Article  CAS  PubMed  Google Scholar 

  96. Kim YW, Kwon JH, Chung E, et al. Short term virologic efficacies of telbivudine versus entecavir against hepatitis B-related hepatocellular carcinoma. Gastroenterol Res Pract. 2015;2015:181065.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Xiang-Ming Lao.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, XJ., Lao, XM., Shi, M. et al. Changes of HBV DNA After Chemoembolization for Hepatocellular Carcinoma and the Efficacy of Antiviral Treatment. Dig Dis Sci 61, 2465–2476 (2016). https://doi.org/10.1007/s10620-016-4167-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-016-4167-5

Keywords

Navigation