HBV Reactivation After Bariatric Surgery for HBV-Infected Obese Patients (original) (raw)

Abstract

Background

The association between non-alcoholic fatty liver disease and hepatitis B virus (HBV) infection is inconclusive. The aim of this study was to investigate the viral dynamic of HBV and its association with change of body mass index (BMI), aspartate transaminase (AST), and alanine transaminase (ALT) levels after bariatric surgery.

Methods

Patients who underwent bariatric surgery between June 2011 and May 2014 were selected in this retrospective study. BMI, AST, ALT, and HBV DNA levels were calculated pre-operatively and at 1st, 3rd, and 6th postoperative months.

Results

Two hundred and seventy-nine patients including 34 (12.2%) HBsAg-positive and 245 (87.8%) HBsAg-negative patients were enrolled. Eighteen HBsAg-positive and HBeAg-negative patients were matched with 36 HBsAg-negative patients. A significant decrease in BMI was found since 1st postoperative month in both groups. AST and ALT increased at 1st postoperative month, but decreased at 3rd and 6th postoperative months in both groups. However, a significant increase in HBV DNA level was observed in HBeAg-negative patients since 1st postoperative month with the highest peak at 3rd postoperative month. HBV reactivation occurred in 4 out of 17 (23.5%) patients, 8 out of 16 (50.0%) patients, and 4 out of 12 (33.3%) patients at 1st, 3rd, and 6th postoperative months, respectively. The change of HBV DNA was not associated with change of BMI, AST, or ALT after bariatric surgery.

Conclusion

Bariatric surgery can achieve significant weight loss and improvement of liver function tests. However, there existed significant risk of HBV reactivation after bariatric surgery for patients with obesity.

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Abbreviations

HBV:

Hepatitis B virus

BMI:

Body mass index

AST:

Aspartate transaminase

ALT:

Alanine transaminase

NAFLD:

Nonalcoholic fatty liver disease

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Funding

This study was supported by research grants from E-Da Hospital, Taiwan (EDAHP108003 and EDAHP109004).

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology and Hepatology, I-Shou University, E-Da Hospital, Kaohsiung, Taiwan
    Chi-Ming Tai
  2. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
    Chi-Ming Tai
  3. Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    Hung-Pin Tu
  4. Department of Pathology, Lin Shin Hospital, Taichung, Taiwan
    Jau-Chung Hwang
  5. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tz-You 1st road, Kaohsiung, Taiwan
    Ming-Lun Yeh, Chung-Feng Huang & Ming-Lung Yu
  6. School of Medicine and Hepatitis Research Center, College of Medicine, and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan
    Ming-Lun Yeh, Chung-Feng Huang & Ming-Lung Yu
  7. National Pingtung University of Science and Technology, Pingtung, Taiwan
    Ming-Lung Yu

Authors

  1. Chi-Ming Tai
  2. Hung-Pin Tu
  3. Jau-Chung Hwang
  4. Ming-Lun Yeh
  5. Chung-Feng Huang
  6. Ming-Lung Yu

Corresponding author

Correspondence toMing-Lung Yu.

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Ethics Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare no competing interests.

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Key points

• Bariatric surgery can achieve significant weight loss and improvement of liver function tests.

• A significant increase in HBV DNA level was observed in HBeAg-negative patients after bariatric surgery.

• The change of HBV DNA was not associated with change of BMI, AST, or ALT after bariatric surgery.

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Tai, CM., Tu, HP., Hwang, JC. et al. HBV Reactivation After Bariatric Surgery for HBV-Infected Obese Patients.OBES SURG 32, 3332–3339 (2022). https://doi.org/10.1007/s11695-022-05979-0

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