Effect of HBV-HDV co-infection on HBV-HCC co-recurrence in patients undergoing living donor liver transplantation.

Abstract

PURPOSE:

To evaluate the effect of hepatitis D virus (HDV) on hepatitis B virus-hepatocellular carcinoma (HBV-HCC) co-recurrence in patients undergoing living donor liver transplantation (LDLT) for HBV alone or HBV-HDV coinfection.

METHODS:

Between 2002 and 2019, 254 HBV-HCC patients underwent LDLT. The patients were divided into two groups after the application of the exclusion criteria: HBV-HCC (Group B; n = 163) and HBV-HDV-HCC (Group D; n = 31). First, the B and D groups were compared in terms of demographic and clinical parameters. Second, patients with (n = 16) and without (n = 178) post-transplant HBV-HCC co-recurrences were grouped and compared in terms of the same parameters.

RESULTS:

Although the risk of HBV-HCC co-recurrence in group D was 4.99-fold higher than in group B, the risk of HBV recurrence alone in group D was 12.5-fold lower than in group B. The AFP (OR = 4.4), Milan criteria (beyond; OR = 18.8), and HDV (OR = 8.1) were identified as the independent risk factors affecting post-transplant HBV-HCC co-recurrence. The Milan criteria (OR = 2.1) and HBV-HCC co-recurrence (OR = 10.9) were identified as the risk factors affecting post-transplant mortality. HBV-HCC co-recurrence developed in 26.5% of patients in Group B and 100% in Group D (OR = 40; p = 0.001). HCC recurrence alone developed in 10% of patients without HBV recurrence in group B and 0% of patients without HBV recurrence in group D (OR = 5.7).

CONCLUSION:

This study showed that the risk of HBV recurrence alone was reduced by 12.5-fold in the presence of HDV; however, the HCC recurrence occurred in all patients with HDV when HBV recurrence developed.

• Authors: Adil Baskiran, Sami Akbulut, Tevfik Tolga Sahin, Cemalettin Koc, Serdar Karakas, Volkan Ince, Cihan Yurdaydin, Sezai Yilmaz
• Journal: Hepatology international (Hepatol Int) Vol. 14 Issue 5 Pg. 869-880 (Sep 2020) ISSN: 1936-0541 [Electronic] United States
• PMID: 32895876 (Publication Type: Journal Article)

Topics

• Adult
• Carcinoma, Hepatocellular (epidemiology, pathology, surgery, virology)
• Coinfection (epidemiology, virology)
• Female
• Hepatitis B virus (isolation & purification, pathogenicity)
• Hepatitis B, Chronic (complications, diagnosis, epidemiology, physiopathology)
• Hepatitis D (complications, diagnosis)
• Hepatitis Delta Virus (isolation & purification)
• Humans
• Liver Neoplasms (epidemiology, pathology, surgery, virology)
• Liver Transplantation (adverse effects, methods)
• Male
• Postoperative Complications (diagnosis, physiopathology, virology)
• Recurrence
• Risk Assessment
• Risk Factors
• Turkey (epidemiology)