Chronic hepatitis virus infection in patients with multiple myeloma: clinical characteristics and outcomes

Abstract

OBJECTIVES:Cytotoxic agents and steroids are used to treat lymphoid malignancies, but these compounds may exacerbate chronic viral hepatitis. For patients with multiple myeloma, the impact of preexisting hepatitis virus infection is unclear. The aim of this study is to explore the characteristics and outcomes of myeloma patients with chronic hepatitis virus infection.METHODS:From 2003 to 2008, 155 myeloma patients were examined to determine their chronic hepatitis virus infection statuses using serologic tests for the hepatitis B (HBV) and C viruses (HCV). Clinical parameters and outcome variables were retrieved via a medical chart review.RESULTS:The estimated prevalences of chronic HBV and HCV infections were 11.0% (n = 17) and 9.0% (n = 14), respectively. The characteristics of patients who were hepatitis virus carriers and those who were not were similar. However, carrier patients had a higher prevalence of conventional cytogenetic abnormalities (64.3% vs. 25.0%). The cumulative incidences of grade 3-4 elevation of the level of alanine transaminase, 30.0% vs. 12.0%, and hyperbilirubinemia, 20.0% vs. 1.6%, were higher in carriers as well. In a Kaplan-Meier analysis, carrier patients had worse overall survival (median: 16.0 vs. 42.4 months). The prognostic value of carrier status was not statistically significant in the multivariate analysis, but an age of more than 65 years old, the presence of cytogenetic abnormalities, a beta-2-microglobulin level of more than 3.5 mg/L, and a serum creatinine level of more than 2 mg/dL were independent factors associated with poor prognosis.CONCLUSION:Myeloma patients with chronic hepatitis virus infections might be a distinct subgroup, and close monitoring of hepatic adverse events should be mandatory.

How Often Are Major Blood-Borne Pathogens Found in Eye Patients? A Serosurvey at an Eye Hospital in Southern China

“…Studies on the prevalence of blood-borne pathogen infections in different patients, such as those with chronic renal failure [18], myeloma patients [19], those with sickle cell diseases [41] and those with mental diseases [42] have been studied. To our knowledge, this is the first report to determine the infection status of four pathogens in eye patients.…”

“…For example, in an Indian study with 256 patients with chronic renal failure (138 had renal transplant and 118 were on maintenance haemodialysis), 7% were infected with HBV, 46% were infected with HCV [18]. The prevalence of HBV and HCV infection in 155 myeloma patients was reported as 11% and 9%, respectively, in Taiwan [19]. In general, the prevalence of infection is higher among hospitalised patients than in the general population.…”

Hepatitis C virus infection and risk of multiple myeloma: Evidence from a meta‐analysis based on 17 case‐control studies

“…The association between chronic HCV infection and lymphoproliferative diseases, including non‐Hodgkin's lymphoma (NHL), Hodgkin's lymphoma (HL) and MM, has been discussed for a long time. Several published studies showed a higher prevalence of HCV infection in MM than health control populations. A cohort study by Duberg et al .…”

Prevention and management of adverse events of Novel agents in multiple myeloma: A consensus of the european myeloma network

“…Preemptive antiviral prophylaxis with nucleoside/nucleotide analogues should be considered in patients with latent or previous HBV infection. 68 Formal recommendation for those with a high risk of HCV infection or with previous infections are not available, but it seems reasonable to screen the high-risk group (anti-HCV and/or HCV RNA) and to treat those with evidence of active infection with modern direct-acting antivirals.…”