HBV reactivation after ICI treatment in patients with HBV infection-related hepatocellular carcinoma and its relationship with hepatic injury events
OBJECTIVE To explore hepatitis B virus(HBV)reactivation after immune checkpoint inhibitor(ICI)treatment in patients with HBV infection-related hepatocellular carcinoma and its relationship with hepatic injury events.METHODS A total of 120 patients with hepatocellular carcinoma between May 2020 and May 2022 in Zhongda Hospital Affiliated to Southeast University were selected,and all of whom treated with ICI.According to the patients'HBV-DNA loads before and after 4 cycles of treatment,those with an absolute value of HBV DNA exceeding 105 copies/ml or with an increase of more than 10-fold compared with the basal value were included in the reactivation group,and those who did not meet the above criteria were included in the non-reactivation group.The risk factors of HBV reactivation were analyzed,the incidence of hepatic injury events was compared between the two groups,and the relationship between HBV-DNA load and the degree of liver injury after treatment was analyzed.RESULTS After 120 patients with HBV infection-related hepatocellular carcinoma were treated with ICI,there were 19 cases(15.83％ )with HBV reactivation.Pre-treatment HBV DNA load ≥103 copies/ml was a risk factor for HBV reactivation after ICI treatment,and receiving antiviral therapy was a protective factor for preven-ting HBV reactivation(P＜0.05).The incidence of liver injury in reactivation group was 36.84％ ,higher than that in non-reactivation group(P=0.016),the difference in the incidence of severe liver injury was not statistically sig-nificant(P=0.462).The difference in the level of liver function indexes before ICI treatment between the reactiva-tion group and the non-reactivation group was not statistically significant.After ICI treatment,the liver function indicators of aspartate aminotransferase(AST),alanine aminotransferase(ALT),and total bilirubin(TBIL)in the reactivated group were(77.51±9.15)U/L,(73.44±8.27)U/L,and(34.66±4.93)μmol/L,respectively,higher than those in the non-reactivated group(P＜0.05).The results of Pearson correlation analysis showed that replication level of HBV DNA was positively correlated with ALT,AST and TBIL after ICI treatment(r=0.623,0.548,0.517,P all＜0.05).CONCLUSION ICI treatment can increase the risk of HBV reactivation in patients with HBV infection-related hepatocellular carcinoma to a certain extent,and HBV reactivation can trigger the oc-currence of hepatic injury events and aggravate the degree of hepatic injury in patients.
Liver cancerHepatitis B virusImmune checkpoint inhibitorVirus reactivationLiver injury event
NETL
NSTL
万方数据
