Relationships between hepatitis B infection status and liver dysfunction after chemotherapy of lung cancer patients in mainland China

Abstract

A preliminary analysis on the risk factors of liver dysfunction was made after the investigation of hepatitis B prevalence and chemotherapy-related hepatic dysfunction occurrence for patients with lung cancer. Consecutively diagnosed 950 lung cancer patients treated in Huashan Hospital, Fudan University from 1999 to 2009 were enrolled in the study. We investigated hepatitis B (HB) prevalence and analyzed chemotherapy-related hepatic dysfunction occurrence and its influencing factors. Liver dysfunction was considered when alanine transaminase, aspartate aminotransferase, and serum bilirubin levels exceeded at least 1.25-fold of normal levels, and HB statuses were categorized into diagnosed HB, previous HB infection, HB immunity, and no HB infection. Among the 950 lung cancer patients, 632 accepted the HB serum marker tests: 8.4 % (53/632) were HB surface antigen positive, and 37.2 % (235/632) were HB core antibody positive. A number of 281 patients received liver function follow-up examinations after they underwent a total of 774 chemotherapy courses, and 34 liver dysfunctions were detected. A logistic regression analysis showed that younger age at diagnosis (≤60 years; P = 0.029) and abnormal liver function before chemotherapy (P = 0.000) were the risk factors for liver dysfunctions after chemotherapy, but HB status had no influence. The screening rates for serum HB marker and HB prevalence in patients with lung cancer were high in mainland China. Lung cancer patients with abnormal liver function before chemotherapy and in younger ages had higher risks for liver dysfunctions after chemotherapies, whereas HB status before the first chemotherapy is not an independent impact factor for post-treatment liver dysfunctions.