Relation of Reduction of Antibodies against Hepatitis B Virus to Hepatocellular Carcinoma Recurrence in the Patients with Resolved Hepatitis B Virus Infection Following Direct-acting Antiviral Therapy for Hepatitis C Virus Infection.

Kouji Joko, Toshie Mashiba, Hironori Ochi, Ryo Yano, Kaori Sato, Yusuke Okujima, Michiko Aono, Nobuaki Azemoto, Shunji Takechi, Tomoyuki Yokota, Ryosuke Jinoka, Yasunori Moriyama, Masataka Nishiyama
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Abstract

Background: A possible interaction of hepatitis viruses at cellular and molecular levels has been suggested. Eradication of hepatitis C virus (HCV) has been reported to induce activation of hepatitis B virus (HBV)-related liver diseases.

Materials and methods: The present study examined association of HBV markers with recurrence of hepatocellular carcinoma (HCC) in patients with resolved HCV infection by direct-acting antiviral (DAA) therapy. In a patient pool of 378 patients with sustained virologic response (SVR) by DAA, the antibody to the hepatitis B surface antigen (anti-HBs), the antibody to the hepatitis B core antigen (anti-HBc), and HBV-DNA levels were estimated before and at the end of DAA therapy. These patients were HBsAg negative. Eighty-nine patients had a history of curative treatment of HCC by resection or radiofrequency ablation. A Cox proportional hazards model was used to identify risk factors for HCC recurrence, including the change ratio of the antibody against HBV proteins.

Results: Although 188 patients had resolved HBV infection, no patient showed HBV reactivation, but anti-HBs and anti-HBc levels decreased significantly. No significant difference in the HCC recurrence rate was evident between patients with and without resolved HBV infection. Changes of immune responses to HBV proteins did not affect HCC recurrence after DAA therapy for HCV infection in this cohort.

Conclusion: The mechanisms underlying diverse roles of DAA-induced SVR of HCV on HBV kinetics need to be resolved in future.

How to cite this article: Joko K, Mashiba T, Ochi H, et al. Relation of Reduction of Antibodies against Hepatitis B Virus to Hepatocellular Carcinoma Recurrence in the Patients with Resolved Hepatitis B Virus Infection Following Direct-acting Antiviral Therapy for Hepatitis C Virus Infection. Euroasian J Hepato-Gastroenterol 2019;9(2):78-83.

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丙型肝炎病毒直接抗病毒治疗后乙型肝炎病毒感染消退患者抗乙型肝炎病毒抗体降低与肝癌复发的关系
背景:肝炎病毒可能在细胞和分子水平上相互作用。据报道,根除丙型肝炎病毒(HCV)可诱导乙型肝炎病毒(HBV)相关肝脏疾病的激活。材料和方法:本研究探讨了直接作用抗病毒(DAA)治疗的HCV感染消退患者中HBV标志物与肝细胞癌(HCC)复发的关系。在378例DAA持续病毒学应答(SVR)的患者池中,在DAA治疗前和结束时评估乙型肝炎表面抗原抗体(anti-HBs),乙型肝炎核心抗原抗体(anti-HBc)和HBV-DNA水平。这些患者均为HBsAg阴性。89例患者有肝癌切除术或射频消融术的根治史。采用Cox比例风险模型确定HCC复发的危险因素,包括抗HBV蛋白抗体的变化比例。结果:188例患者HBV感染得到缓解,无患者出现HBV再活化,但anti-HBs和anti-HBc水平明显下降。HBV感染消退和未消退患者的HCC复发率无明显差异。在该队列中,对HBV蛋白免疫反应的改变不影响丙肝感染DAA治疗后的HCC复发。结论:daa诱导的HCV SVR对HBV动力学的不同作用机制有待进一步研究。如何引用本文:Joko K, Mashiba T, Ochi H,等。丙型肝炎病毒直接抗病毒治疗后乙型肝炎病毒感染消退患者抗乙型肝炎病毒抗体降低与肝癌复发的关系中华肝病杂志,2019;9(2):78-83。
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