Clinical Characteristics and Viral Reactivation of Immune Checkpoint Inhibitors in the Treatment of HBV-Related Hepatocellular Carcinoma
Objective To investigate the clinical characteristics,HBV reactivation,and hepatotoxicity of patients with HBV-infected hepatocellular carcinoma(HCC)who treated with ICIs.Methods A total of 57 patients with hepatocellular carcinoma were ret-rospectively collected as study subjects,and they were divided into the non-HBV-infected hepatocellular carcinoma group(n=10)and the HBV-infected hepatocellular carcinoma group(n=47)according to whether they were HBsAg positive or not.Results There were no significant differences in all aspects of comparison between the two groups in terms of gender,age,ICIs category,combined treat-ment or not,cirrhosis status,intrahepatic metastasis,hypertension,coronary heart disease,smoking and drinking history,and initial alpha-fetoprotein(AFP)value(P＞0.05).There were statistically significant differences in terms of ICI type,history of underlying hepatic disease,baseline prothrombin time(PT)and international normalized ratio(INR)(P＜0.05).Forty-one patients(71.9％)devel-oped whole-grade immune liver injury(IMH).Four patients(7.02％)developed HBV reactivation during treatment with ICIs,which occurred at a median time of 6 months.Four patients(7.02％)received antiviral therapy,of which three were entecavir and one tenofovir-based.Conclusion Reactivation of HBV can occur in patients with HBV-associated hepatocellular carcinoma treated with ICIs and lead to secondary liver injury.HBV-infected patients receiving ICIs treatment should receive routine prophylactic antiviral therapy and undergo regular monitoring for HBV-DNA.
Hepatitis B reactivationImmune checkpoint inhibitorsLiver toxicityLiver cancer
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