High Hepatitis B Virus DNA Level in Serum before Liver Transplantation Increases the Risk of Hepatocellular Carcinoma Recurrence

Aim: To analyze the relationship between hepatitis B virus (HBV) and hepatocellular carcinoma (HCC) recurrence in orthotopic liver transplantation (OLT) patients. Methods: 340 HBV patients with OLT were included in the study; among them were 148 patients with HBV-associated HCC. Results: HCC recurrence rates at 1, 3 and 5 years were 21, 29, and 46%, respectively. Exceeding Milan criteria (hazard ratio, HR = 12.35; 95% confidence interval, CI, 2.80–54.49; p = 0.001), HBV DNA level >5 log10 copies/ml before transplant (HR = 2.45; 95% CI 1.10–5.45; p = 0.03) and HBV recurrence (HR = 2.27; 95% CI 1.10–4.75; p = 0.03) were significant independent predictors of HCC recurrence. HBV DNA >5 log10 copies/ml before transplant (HR = 8.65; 95% CI 3.40–21.98; p < 0.001) and concomitance with HCC (HR = 2.79; 95% CI 1.33–5.87; p = 0.007) were predictors of HBV recurrence. Further stratified analysis showed that HBV recurrence was more prevalent in the HCC recurrence group (HR = 4.58; 95% CI 1.88–11.12; p = 0.001). Conclusions: There is a close relationship between HBV and HCC recurrence after transplant. High HBV DNA levels before transplant are associated with HCC recurrence after transplant.