Analysis of Related Factors for Hepatic Toxicity in Breast Cancer with Hepatitis B Virus Infection during Chemotherapy

OBJECTIVE To study the incidence and related factors for hepatic toxicity in breast cancer with HBV infection during chemotherapy. METHODS We used ELISA to detect the serum markers of HBV and liver function in 908 breast cancer patients. Serum HBV DNA was quantified by PCR-fluorescence probing. The hepatic toxicity was analyzed with regard to toxicity according to CTCAE v. 4.03. RESULTS After 2, 4, 6 course of chemotherapy, the incidences of grade 1-4 hepatic toxicity were 22.9%, 31.1%, 25.9% and 24.7%, 25.4%, 20.8%, respectively in breast cancer with and without HBV infection(P=0.533, P=0.061, P=0.085); ≥grade 2 were 3.3%, 6.9%, 2.7% and 4.6%, 1.9%, 1.9%, respectively in breast cancer with and without HBV infection(P=0.395, P=0.000, P=0.491). Development of ≥grade 2 hepatic toxicity for breast cancer with HBV infection was significantly more common in the 36-55 years(P=0.001), CAF→T(P=0.004), fatty liver(P=0.035) and steroid(P=0.001). HBV reactivation was obtained in seventeen breast cancer patients with HBV infection during chemotherapy. All of them had developed ≥grade 2 hepatic toxicity. CONCLUSION HBV infection was more likely to cause patients with breast cancer to develop ≥grade 2 hepatic toxicity after four courses of chemotherapy. 36-55 years, CAF→T, fatty liver and steroid were associated with higher risk of ≥grade 2 hepatic toxicity in breast cancer patients with HBV infection during chemotherapy.