Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

The Change of HBV DNA Titer after Hepatic Resection in Hepatitis B Patients with Hepatocelluar Carcinoma

B형 간염 간세포암 환자에서의 간절제 후 혈청 HBV DNA 역가의 변화

  • Lee, Hae-Won (Department of Surgery, Seoul National University College of Medicine) ;
  • Suh, Kyung-Suk (Department of Surgery, Seoul National University College of Medicine) ;
  • Kim, Joo-Hyun (Department of Surgery, Seoul National University College of Medicine) ;
  • Shin, Woo-Young (Department of Surgery, Seoul National University College of Medicine) ;
  • Yi, Nam-Joon (Department of Surgery, Seoul National University College of Medicine) ;
  • Lee, Kuhn-Uk (Department of Surgery, Seoul National University College of Medicine)
  • 이해원 (서울대학교 의과대학 외과학교실) ;
  • 서경석 (서울대학교 의과대학 외과학교실) ;
  • 김주현 (서울대학교 의과대학 외과학교실) ;
  • 신우영 (서울대학교 의과대학 외과학교실) ;
  • 이남준 (서울대학교 의과대학 외과학교실) ;
  • 이건욱 (서울대학교 의과대학 외과학교실)
  • Published : 2010.03.30
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Abstract

Purpose: Reactivation of hepatitis B virus (HBV) replication after hepatic resection might be a significant risk factor for prognosis in patients with chronic hepatitis B. The purpose of the present study was to investigate the changing pattern of serum HBV DNA titer after hepatic resection and to assess the incidence of reactivation of HBV replication. Methods: Among HBV-positive patients who underwent hepatic resection for hepatocellular carcinoma, thirty-six patients with preoperative serum HBV DNA titer ${\geq}$3 $log_{10}$copies/mL were enrolled. Serum DNA titers were examined before the operation, on the second and seventh postoperative days, and one month after the operation. Results: The serum DNA titer decreased on the second postoperative day (p=0.078). The DNA level, however, had substantially returned to preoperative values by the seventh postoperative day (p<0.001). For most patients, the postoperative DNA titer reached its zenith on the seventh postoperative day or one month after the operation. The zenith level was higher (by 0.49${\pm}$0.25 log10copies/mL) than preoperative levels although this difference just missed significance (p=0.068). Although postoperative reactivation of HBV replication emerged in 6 patients, only one of those patients developed postoperative hepatitis. Overall, four patients developed postoperative hepatitis and all of them had high postoperative HBV DNA levels (over 6 log10copies/mL). Conclusion: Although serum HBV DNA titers tended to increase postoperatively, routine antiviral therapy might be unnecessary because of the low incidence of postoperative hepatitis. High postoperative DNA levels, however, might be a risk factor for hepatitis, and postoperative follow-up of serum HBV DNA levels might be necessary in HBV-positive patients with hepatic resection.

Keywords

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