Timing Of Antiviral Therapy On Hepatitis B Virus Carriers With Malignant Tumors During Perichemotherapy

Objective: The purpose of this study is to observe the clinical efficacy of antiviral therapy for inactive HBs Ag carriers combined with malignant tumors at different periods,and to analyze whether they need to receive antiviral therapy as soon as possible,and then to explore the optimal course of antiviral therapy for such patients.It provides a basis for further rationally optimizing medical resources,shortening the course of antiviral treatment,improving the quality of life of patients and saving medical expenses.Methods: A total of 2856 patients with malignant tumors who were admitted to Qian Xi Nan People’s Hospital from April 1,2013 to October 1,2019 were collected.Among them,60 patients with inactive HBs Ag carriers who were receiving chemotherapy were screened out,including 24 cases in the treatment group: given entecavir(ETV)for antiviral therapy before chemotherapy;36 cases in the control group: not given antiviral therapy before chemotherapy,and antiviral treatment was added with ETV only when its transaminase continued to rise or HBV DNA turned positive.Differences in HBV DNA changes,liver damage and delayed chemotherapy were compared between the two groups during different deliver periods.Results: In the treatment group,24 patients were given ETV antiviral therapy before chemotherapy.One patient(4.2%)had HBV reactivation and HBV DNA did not turn negative at the end of chemotherapy;Three patients(12.5%)had liver injury,one returned to normal liver function at the end of chemotherapy,and the other two patients remained abnormal.Among the 36 patients in the control group who were not given ETV antiviral therapy before chemotherapy,8 patients(22.22%)were temporarily treated with ETV antiviral therapy during chemotherapy,7 patients(19.44%)were reactivated due to HBV and given ETV antiviral treatment in time,5 cases of HBV DNA turned negative and 2 cases of HBV DNA did not turn negative;There were 13 patients(36.11%)of thegroup with liver injury after liver protection treatment,4 cases of liver function returned to normal liver function at the end of chemotherapy and 9 cases of liver function failed to recover,with no statistically significant difference between the two groups(P>0.05).The antiviral treatment effect before and during chemotherapy were observed,and there were obvious differences of liver function and HBV DNA at the end of chemotherapy between the two groups(P>0.05).None of the 7 patients with HBV reactivation and 13 patients with liver injury had liver failure or delayed chemotherapy.Conclusion: For inactive HBs Ag carriers with malignant tumor,antiviral drugs should be added timely when the reactivation of HBV DNA is detected or when the transaminase(ALT)is greater than 2 times the normal value after chemotherapy,antiviral drugs can be added to achieve the ideal.which can not only achieve ideal curative effect,but also save treatment cost.