Hepatocellular carcinoma is associated with an increased risk of hepatitis B virus recurrence after liver transplantation. Faria, L. C., Gigou, M., Roque-Afonso, A. M., Sebagh, M., Roche, B., Fallot, G., Ferrari, T. C., Guettier, C., Dussaix, E., Castaing, D., Brechot, C., & Samuel, D. Gastroenterology, 134(7):1890–9; quiz 2155, June, 2008.
abstract   bibtex   
BACKGROUND & AIMS: Hepatitis B virus (HBV) recurrence after orthotopic liver transplantation (OLT) is significantly reduced by prophylaxis with hyperimmune antibody to hepatitis B surface antigen (anti-HBs) globulins (HBIG) and antiviral drugs. The role of hepatocellular carcinoma (HCC) in HBV recurrence remains unclear. We investigated the association between HCC pre-OLT and HBV recurrence post-OLT. METHODS: We studied 99 hepatitis B surface antigen-positive patients who underwent OLT for cirrhosis. The median follow-up period was 43 months. All patients received HBIG, and 51 also received lamivudine and/or adefovir. Of these 99 patients, 31 had HCC before OLT. Total HBV DNA and covalently closed circular (ccc)-DNA were measured in tumor and nontumor tissues from the explanted livers of 16 of these 31 HCC patients and, also, in a context of tumor recurrence, in 3 patients who developed HBV/HCC recurrence. RESULTS: Fourteen patients (14.1%) developed HBV recurrence within a median period of 15 months post-OLT. HCC at OLT, a pre-OLT HBV DNA viral load \textgreater or = 100,000 copies/mL, and HBIG monoprophylaxis were independently associated with HBV recurrence post-OLT. Eleven out of the 31 patients with HCC at OLT presented with HBV recurrence and 3 out of the 68 patients without HCC had HBV recurrence (P \textless .0001). HBV recurrence was more frequent in patients who developed HCC recurrence (7/8 patients, 87.5%) than in those who did not (4/23 patients, 17.4%) (P \textless .0001). In the 16 explanted livers, cccDNA was detectable in HCC cells in 11 and in nontumor cells in 12. cccDNA was detected in a context of HCC recurrence in 2 of the 3 patients tested who developed HBV/HCC recurrence. CONCLUSIONS: The associations of HCC pre-OLT, and HCC recurrence with HBV recurrence post-OLT, and the detection of HBV DNA and cccDNA in HCC suggest that HBV replication in tumor cells may contribute to HBV recurrence post-OLT.
@article{faria_hepatocellular_2008,
	title = {Hepatocellular carcinoma is associated with an increased risk of hepatitis {B} virus recurrence after liver transplantation},
	volume = {134},
	issn = {1528-0012 (ELECTRONIC); 0016-5085 (LINKING)},
	shorttitle = {Hepatocellular carcinoma is associated with an increased risk of hepatitis {B} virus recurrence after liver transplantation},
	abstract = {BACKGROUND \& AIMS: Hepatitis B virus (HBV) recurrence after orthotopic liver transplantation (OLT) is significantly reduced by prophylaxis with hyperimmune antibody to hepatitis B surface antigen (anti-HBs) globulins (HBIG) and antiviral drugs. The role of hepatocellular carcinoma (HCC) in HBV recurrence remains unclear. We investigated the association between HCC pre-OLT and HBV recurrence post-OLT. METHODS: We studied 99 hepatitis B surface antigen-positive patients who underwent OLT for cirrhosis. The median follow-up period was 43 months. All patients received HBIG, and 51 also received lamivudine and/or adefovir. Of these 99 patients, 31 had HCC before OLT. Total HBV DNA and covalently closed circular (ccc)-DNA were measured in tumor and nontumor tissues from the explanted livers of 16 of these 31 HCC patients and, also, in a context of tumor recurrence, in 3 patients who developed HBV/HCC recurrence. RESULTS: Fourteen patients (14.1\%) developed HBV recurrence within a median period of 15 months post-OLT. HCC at OLT, a pre-OLT HBV DNA viral load {\textgreater} or = 100,000 copies/mL, and HBIG monoprophylaxis were independently associated with HBV recurrence post-OLT. Eleven out of the 31 patients with HCC at OLT presented with HBV recurrence and 3 out of the 68 patients without HCC had HBV recurrence (P {\textless} .0001). HBV recurrence was more frequent in patients who developed HCC recurrence (7/8 patients, 87.5\%) than in those who did not (4/23 patients, 17.4\%) (P {\textless} .0001). In the 16 explanted livers, cccDNA was detectable in HCC cells in 11 and in nontumor cells in 12. cccDNA was detected in a context of HCC recurrence in 2 of the 3 patients tested who developed HBV/HCC recurrence. CONCLUSIONS: The associations of HCC pre-OLT, and HCC recurrence with HBV recurrence post-OLT, and the detection of HBV DNA and cccDNA in HCC suggest that HBV replication in tumor cells may contribute to HBV recurrence post-OLT.},
	number = {7},
	journal = {Gastroenterology},
	author = {Faria, L. C. and Gigou, M. and Roque-Afonso, A. M. and Sebagh, M. and Roche, B. and Fallot, G. and Ferrari, T. C. and Guettier, C. and Dussaix, E. and Castaing, D. and Brechot, C. and Samuel, D.},
	month = jun,
	year = {2008},
	keywords = {Adenine/analogs \& derivatives/therapeutic use Adolescent Adult Aged Antiviral Agents/therapeutic use Carcinoma, Circular/analysis DNA, DNA Time Factors Treatment Outcome Viral Load Virus Replication, Hepatocellular/drug therapy/surgery/ virology DNA},
	pages = {1890--9; quiz 2155}
}
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