Clinical analysis of liver injury and hepatitis B virus reactivation after chemotherapy in HBsAg-positive patients with malignant tumors

Objective To investigate the occurrence of liver injury and related risk factors for hepatitis B virus( HBV) reactivation after chemotherapy in HBsAg- positive patients with malignant tumors. Methods A total of 150 HBsAg- positive patients with malignant tumors who received chemotherapy in Shantou Central Hospital from January 2011 to December 2013 were collected; 43 patients received prophylactic antiviral therapy,i. e.,the application of antiviral therapy before,during,and within half a year after chemotherapy( experiment group),and 107 patients did not receive prophylactic antiviral therapy( control group). The occurrence of liver injury after chemotherapy in both groups was analyzed retrospectively. Chi- square test was applied for comparison of categorical data between the two groups,and logistic regression analysis was used to investigate the related factors for HBV reactivation after chemotherapy. Results Of all,64 patients( 42. 0%) experienced liver injury after chemotherapy,including 13 grade Ⅰ cases( 8. 7%),29 grade Ⅱ cases( 19. 3%),15 grade Ⅲcases( 10. 0%),and 6 grade Ⅳ cases( 4. 0%),and the liver injury grade differed significantly between the two groups( χ2= 19. 498,P = 0. 001). The experiment group had a significantly lower incidence of liver injury than the control group( 18. 6% [8 cases] vs 52. 3%[56 cases]; χ2= 25. 864,P < 0. 001). The univariate logistic regression analysis showed that there were significant differences in six parameters of hepatitis B before chemotherapy,HBV quantification,application of hormones,and application of prophylactic antiviral therapy between the two groups. The multivariate logistic regression analysis of these four factors showed that they were all independent influencing factors for HBV reactivation after chemotherapy,and prophylactic antiviral therapy was the only protective factor. Conclusion HBsAg-positive patients with malignant tumors have a high incidence of liver injury after chemotherapy,and prophylactic antiviral therapy can effectively reduce the incidence of HBV reactivation and liver injury after chemotherapy in HBsAg- positive patients.