Objective: 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 (T_baseline), at 24 hours (T_{post 24hrs}) and 48 hours (T_{post 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 T_{post 24hrs} and T_{post 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 T_{post 24hrs}, P < 0.05, and the total ratio of B cells was significantly increased at T_{post 24hrs}, P < 0.05. Compared with the values at T_{post 24hrs}, the total ratio of CD4⁺ T cells, CD4⁺/CD8⁺ T cells, and the total ratio of B cells were significantly increased at T_{post 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