Prophylactic Antiviral Therapy Before Hepatectomy Is Beneficial to HBV-Related Hepatocellular Carcinoma Patients with Negative HBV-DNA

Abstract

The purpose of this study was to explore the role of prophylactic antiviral therapy in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients with negative HBV-DNA. The study included 79 HBV-related HCC patients with preoperative negative HBV-DNA who underwent hepatectomy. Patients were prospectively assigned to two groups: preoperative antiviral treatment group (n = 39) and untreated group (n = 40). Follow-up visits were performed with patients regularly once per month. The data for the two groups were analyzed including HBV activation; tumor recurrence; liver function; 1-, 2-, and 3-year survival rate; and cumulative survival time. In the antiviral group, 1 of 39 (2.56%) patients had HBV activation, while there were 8 of 40 (20%) with HBV activation in the untreated group (p < 0.05). Our findings indicate, therefore, that antiviral therapy is a protective factor for HBV activation. There was no statistically significant difference in tumor recurrence between the two groups. Tumor recurrence is related to non-antiviral status, postoperative HBV activation, level of AFP, tumor invasion, and tumor microinvasion (p < 0.05). Postoperative 1-, 2-, and 3-year cumulative overall survival rates were 92.30%, 84.61%, and 76.33%, respectively, for the antiviral groups, and 90%, 72.5%, and 54.28%, respectively, for the untreated group (p = 0.048). There was no statistically significant difference in disease-free survival between the two groups (p = 0.120). HBV can be activated after hepatectomy for HBV-related HCC patients who exhibit preoperative negative HBV-DNA. Preventative antiviral treatment for HBV- HCC patients with negative HBV-DNA undergoing hepatic resection facilitates reduction of activation of HBV.