Risks of hepatitis C virus reactivation in a real-life population of oncology patients treated in an academic center
| Autor: | Catherine-Audrey Boutin, Jean-Philippe Adam, Stephane Doucet, Dominic Martel, Valérie Martel-Laferrière |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adult medicine.medical_specialty Carcinoma Hepatocellular Hepatitis C virus medicine.medical_treatment Population Hepacivirus medicine.disease_cause Antiviral Agents 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans Pharmacology (medical) education education.field_of_study Chemotherapy business.industry Incidence (epidemiology) Liver Neoplasms Alanine Transaminase Symptom Flare Up Hepatitis C Viral replication 030220 oncology & carcinogenesis Oncology patients Virus Activation business 030215 immunology Hepatic decompensation |
| Zdroj: | Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. 27(8) |
| ISSN: | 1477-092X |
| Popis: | Background Chemotherapy has been associated with a theoretical risk of hepatitis C virus (HCV) reactivation. However, little is known about the amplitude of viral replication and the incidence of subsequent hepatic exacerbation. Method We aimed to describe the occurrence of hepatitis flare and HCV reactivation at our center. We included, over a period of 5 years, adult patients with chronic HCV receiving intravenous chemotherapy. We excluded patients with undetectable HCV RNA, hepatocellular carcinoma, liver metastases or other etiologies of hepatic disease. The primary objective was to identify hepatic flares (elevation of alanine aminotransferase 3 times above the upper limit of normal). Secondary objectives were to assess viral reactivation (HCVr, HCV-RNA ≥1 log10 IU/mL when compared to baseline value), hepatic decompensation, mortality and the impact on the chemotherapy. Descriptive statistics were used. Results A total of 11 patients with chronic HCV were identified among the 5761 oncology patients. Five patients experienced a hepatic flare with median maximal ALT value of 139 U/L (IQR 133-237). Only 2 patients met criteria for HCVr with a median RNA increase of 1.16 log IU/mL (IQR 1.1-1.2). One patient presented with both HCVr and a hepatic flare. Only one patient required chemotherapy discontinuation following hepatic flare. No hepatic decompensation or related mortality were observed. Conclusion We identified a very small number of HCV cases among our population. We observed HCVr and hepatic flares, but only one consequence on cancer treatment. Nonetheless, HCV screening is encouraged among patients undergoing chemotherapy to allow close follow-up of hepatic function. |
| Databáze: | OpenAIRE |
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