Hepatitis B reactivation during cisplatin-based adjuvant chemotherapy in HBsAg-positive patients with gastric carcinoma / 中华传染病杂志

ABSTRACT

ObjectiveTo retrospectively investigate the incidence,outcome and risk factors of HBV reactivation in HBsAg-positive a patients with gastric carcinoma during cisplatin-based adjuvant chemotherapy.Methods We retrospectively reviewed the records of 2,538 patients with gastric carcinoma who received adjuvant chemotherapy from January 2005 to December 2010.Among these patients,146 HBsAg-positive patients were analyzed for the HBV reactivation in this study.The HBV serology and biochemical tests of the 146 patients were performed.The data were analyzed by chisquare test.Results Among 146 HBsAg-positive patients with gastric carcinoma,43 patients (29.5％) developed hepatitis,of which 29 (19.9％) were related to HBV reactivation.Univariate analysis showed that age ≥51 years (P=0.029) and abnormal liver uhrasonography findings such as fatty liver or early cirrhotic changes (P=0.031) were associated with HBV reactivation.However,gender,HBeAg positive status and the use of corticosteroids were not related with HBV reactivation.Conclusions HBV reactivation occurs in a significant proportion of HBsAg-positive patients with gastric carcinoma during adjuvant cisplatin-based chemotherapy.Once hepatitis developed,most patients could not finish the chemotherapy as planned despite lamivudine treatment.Therefore,HBsAg-positive gastric carcinoma patients should initiate prophylactic antiviral treatment before chemotherapy.