Infection and Drug Resistance (Nov 2022)
Effects of General Anesthesia on Changes of Serum Hepatitis B Virus-DNA Levels in Infected Patients Underwent Non-Hepatobiliary Minimally Invasive Surgery: A Pilot Observational Study
Abstract
Junxian Quan1 *, Xingtong Chen1 *, Xi Tang,1 Xianzhe Liu,1 Jieyu Li,1 Bin Yi,1 Peng Li,2 Kaizhi Lu,1 Jianteng Gu1 1Department of Anesthesiology, The First Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China; 2Department of Pharmacognosy and Traditional Chinese Medicine, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianteng Gu; Kaizhi Lu, Department of Anesthesiology, The First Affiliated Hospital, Third Military Medical University (Army Medical University), 30 Gao Tanyan Street, Chongqing, 400038, People’s Republic of China, Tel +86 23 68766122, Fax +86 23 65463270, Email [email protected]; [email protected]: To investigate the effects of different general anesthesia methods on the changes of serum hepatitis B virus deoxyribonucleic acid (HBV-DNA) levels in the hepatitis B virus (HBV) infected patients.Methods: This pilot prospective observational study was carried out from March 2021 to January 2022. Forty patients infected by HBV, who underwent non-hepatobiliary minimally invasive surgery, were allocated into an intravenous anesthesia group maintained with propofol (Group P, n = 20) and an inhalation anesthesia group maintained with sevoflurane (Group S, n = 20) by a random envelope method. Patient’s blood was drawn before operation (Tbaseline), at 24 hours (Tpost 24hrs) and 48 hours (Tpost 48hrs) after operation to detect the serum HBV-DNA levels and analyze the subset levels of T, B lymphocytes and NK cells (TBNK) in two groups. The serum HBV-DNA level was used as the major outcome, and it was analyzed by repeated-measures analysis of variance after natural logarithm transformation.Results: In Group P and Group S, compared with the baseline, the serum HBV-DNA levels decreased significantly at Tpost 24hrs and Tpost 48hrs, P< 0.05. The total ratio of CD4+T cells and the ratio of CD4+T to CD8+T cells (CD4+/CD8+) were lower at Tpost 24hrs, P< 0.05, and the total ratio of B cells was significantly increased at Tpost 24hrs, P< 0.05. Compared with the values at Tpost 24hrs, the total ratio of CD4+ T cells, CD4+/CD8+ T cells, and the total ratio of B cells were significantly increased at Tpost 48hrs in both groups, P< 0.05. However, there were no statistical differences between Group P and Group S.Conclusion: The levels of serum HBV-DNA decreased within 48 hours after general anesthesia. There were no significant differences between the effects of intravenous and inhalation anesthesia on the serum HBV-DNA levels.Trial Registration: This study has been prospectively registered in the Clinical Trials Registry (NCT02038088, 1/28/2015).Keywords: general anesthesia, hepatitis B virus deoxyribonucleic acid, lymphocyte subsets, immune function
