Acute exacerbation and reactivation of chronic hepatitis C virus infection in cancer patients

Mahale, Parag; Kontoyiannis, Dimitrios P.; Chemaly, Roy F.; Jiang, Ying; Hwang, Jessica P.; Davila, Marta; Torres, Harrys A.

doi:10.1016/j.jhep.2012.07.031

Cited by 115 publications

(149 citation statements)

References 36 publications

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“…However, documentation that the increase in ALT was associated with increase in HCV RNA was available in few patients, and comparison of the frequency of ALT increase with patients without HCV infection was not available. 9 One retrospective case-control study found that the rate of nonrelapsed mortality 1 year after allogeneic stem-cell transplantation was 43% among 31 patients with HCV, compared with 24% among 31 matched controls (P Ͻ .01). 10 Our study had inherent limitations resulting from the retrospective nature of the study design.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported a high proportion of chemotherapy discontinuation among patients with cancer with HCV infection and hepatic flares 9 and a high risk of nonrelapse mortality among those undergoing stem-cell transplantation with HCV infection. 10 Poor outcomes may be attributed to hepatotoxicity in patients with underlying hepatitis C or worsening of hepatitis C because of increased HCV replication.…”

Section: Introductionmentioning

confidence: 99%

“…7 HCV reactivation and hepatic flares during immunosuppressive therapy have been reported among patients with hematologic malignancies and those receiving rituximab therapy. 8,9 However, the incidence and outcomes have not been determined, and thus, it is not clear whether all or selected patients with cancer should be screened for HCV infection before chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Hepatitis C Virus Screening in Patients With Cancer Receiving Chemotherapy

Hwang

Suarez‐Almazor

Torres

et al. 2014

JOP

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Purpose: Reactivation of hepatitis C virus (HCV) replication can occur in patients receiving immunosuppressive therapy. We aimed to determine the prevalence and predictors of HCV screening at the onset of chemotherapy among patients with cancer. Methods:We conducted a retrospective cohort study of adults with cancer who were newly registered at MD Anderson Cancer Center from January 2004 to April 2011 and received chemotherapy. The primary study outcome was HCV antibody (anti-HCV) screening at chemotherapy onset. We calculated screening prevalence and predictors by comparing characteristics of screened and unscreened patients using multivariable logistic regression.Results: A total of 141,877 new patients with cancer were registered at MD Anderson during the study period, of whom 16,773 (11.8%) received chemotherapy and met inclusion criteria. A total of 2,330 patients (13.9%) were screened for HCV, and 35 (1.5%) tested positive. Only 42% of patients with exposure-type HCV risk factors, such as HIV infection, injection drug use, hemodialysis, or hemophilia, were screened. Birth after 1965, Asian race, HCV risk factors, and anticipated rituximab therapy were significant predictors of HCV screening; black patients and patients with solid tumors were significantly less likely to be screened. The only significant predictor of a positive anti-HCV result was birth during 1945 to 1965.Conclusion: HCV screening rates were low, even among patients with risk factors, and the groups with the highest rates of screening did not match the groups with the highest rates of a positive test result. Misconceptions may exist about which patients should be screened for HCV infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hepatitis C Virus Screening in Patients With Cancer Receiving Chemotherapy

Hwang

Suarez‐Almazor

Torres

et al. 2014

JOP

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“…In case of HCV reactivation (≥3 times increase in ALT level and ≥1 log increase in HCV RNA titer), discontinuation of the immunosuppressive treatment must be considered (14,15).…”

Section: Recommendationmentioning

confidence: 99%

Viral hepatitis screening guideline before biological drug use in rheumatic patients

et al. 2016

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Biological drugs (tumor necrosis factor inhibitors, rituximab, tocilizumab, abatacept, and tofacitinib) are important treatment alternatives in rheumatology, particularly for resistant patients. However, they may cause hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivation; for instance, HBV reactivation may occur in a patient who is an inactive hepatitis B surface antigen (HBsAg) carrier or who has resolved HBV infection. Therefore, the screening of patients before biological treatment and the application of a prophylactic treatment, particularly with respect to latent HBV infections, are recommended when necessary. This guideline covers pre-treatment screening and follow-up recommendations, if required, with respect to viral hepatitides in rheumatology patients who are planned to be given biological drugs. Although this guideline is prepared for biological disease-modifying antirheumatic drugs (DMARDs), it is recommended to be used also for target-oriented DMARDS and medium-high dose corticosteroids (>7.5 mg prednisolone/day equivalent). It should be considered that the reactivation risk is higher when more than one immunosuppressive drug is used.

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“…Liver cirrhosis and impaired liver function are, indeed, associated with early toxicity. In fact, more frequently these patients require treatment delay compared with HCV-negative cases [Mahale et al 2012]. Nonetheless, differently from hepatiitis B virus (HBV), the immunosuppression induced by rituximab does not appear to trigger a HCV reactivation.…”

Section: Hcv-associated Diffuse Large B-cell Lymphomasmentioning

confidence: 99%

Hepatitis C virus-associated B-cell non-Hodgkin’s lymphomas: what do we know?

Vannata

Arcaini

Zucca

2015

Therapeutic Advances in Hematology

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Abstract:Epidemiological studies have shown an increased risk of developing B-cell lymphomas in patients with chronic hepatitis C virus (HCV) infection. There is, however, a great geographic variability and it remains unclear whether additional environmental and genetic factors are involved or whether the international discrepancies represent simply a consequence of the variable prevalence of HCV infection in different countries. Other confounding factors may affect the comparability of the different studies, including the method of HCV assessment, the selection of normal controls, the lymphoma classification used and the year of publication. The most convincing evidence for a causal relationship comes from the observation, mainly limited to some indolent subtypes, of B-cell lymphoma regressions after successful HCV eradication with antiviral treatment. Yet, the molecular mechanism of HCV-induced lymphomagenesis are mainly hypothetical. According to most plausible models, lymphoma growth is a consequence of continuous antigenic stimulation induced by the chronic viral infection. This review will summarize the current knowledge on HCV-associated lymphomas and their management.

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Acute exacerbation and reactivation of chronic hepatitis C virus infection in cancer patients

Cited by 115 publications

References 36 publications

Hepatitis C Virus Screening in Patients With Cancer Receiving Chemotherapy

Hepatitis C Virus Screening in Patients With Cancer Receiving Chemotherapy

Viral hepatitis screening guideline before biological drug use in rheumatic patients

Hepatitis C virus-associated B-cell non-Hodgkin’s lymphomas: what do we know?

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