Acute exacerbation and reactivation of chronic hepatitis C virus infection in cancer patients
- PMID:22871500
- DOI:10.1016/j.jhep.2012.07.031
Acute exacerbation and reactivation of chronic hepatitis C virus infection in cancer patients
Abstract
Background & aims:Data on acute exacerbation and reactivation of chronic hepatitis C virus (HCV) infection following chemotherapy are very limited. We sought to characterize the episodes of acute exacerbation and viral reactivation of HCV infection in cancer patients.
Methods:The medical records of HCV-infected patients seen at our institution (2008-2009) were analyzed retrospectively. Acute exacerbation was defined as greater than 3-fold increase in serum level of alanine aminotransferase, and viral reactivation as ≥ 1 log(10) IU/ml increase of HCV viral load following chemotherapy.
Results:Acute exacerbation occurred in 33 (11%) of 308 patients with proven HCV infection. Patients with acute exacerbation more often had underlying hematological malignancies (73% vs. 29%; p<0.001) and lymphopenia (6% vs. 0%; p=0.01) than patients without it. In multivariate analysis, underlying hematological malignancies (p=0.02; odds ratio, 3.2; 95% confidence interval, 1.2-8.7) and use of rituximab (p=0.004; odds ratio, 4.2; 95% confidence interval, 1.6-10.9) were associated with acute exacerbation. Patients with acute exacerbation received higher median cumulative dose of rituximab than those without exacerbation. Discontinuation of chemotherapy due to liver dysfunction was more common in patients with acute exacerbation than in patients without it (45% vs. 11%; p<0.001). Eight (36%) of 22 patients with known pre- and post-chemotherapy viral load had viral reactivation.
Conclusions:Acute exacerbation and reactivation of chronic HCV infection occur often after chemotherapy. Liver dysfunction can lead to discontinuation of potentially life-saving chemotherapy in nearly one-half of the patients with exacerbation of HCV infection.
Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Comment in
-
Focus.J乙醇。2012年12月,57 (6):1161-2. doi: 10.1016/j.jhep.2012.09.012. Epub 2012 Sep 19. J Hepatol. 2012. PMID:23000436 No abstract available.
Similar articles
-
Chronic Hepatitis C: Acute Exacerbation and Alanine Aminotransferase Flare.Viruses. 2023 Jan 8;15(1):183. doi: 10.3390/v15010183. Viruses. 2023. PMID:36680223 Free PMC article. Review.
-
Hepatitis C virus reactivation in patients receiving cancer treatment: A prospective observational study.Hepatology. 2018 Jan;67(1):36-47. doi: 10.1002/hep.29344. Epub 2017 Nov 13. Hepatology. 2018. PMID:28653760 Free PMC article.
-
Risk of Severe Acute Exacerbation of Chronic HBV Infection Cancer Patients Who Underwent Chemotherapy and Did Not Receive Anti-Viral Prophylaxis.PLoS One. 2015 Aug 14;10(8):e0132426. doi: 10.1371/journal.pone.0132426. eCollection 2015. PLoS One. 2015. PMID:26274393 Free PMC article.
-
Predictors of liver fibrosis in HIV-infected patients with chronic hepatitis C virus (HCV) infection: assessment using transient elastometry and the role of HCV genotype 3.Clin Infect Dis. 2006 Apr 1;42(7):1032-9. doi: 10.1086/501021. Epub 2006 Feb 21. Clin Infect Dis. 2006. PMID:16511772
-
Screening and prevention of hepatitis C virus reactivation during chemotherapy.World J Gastroenterol. 2021 Aug 21;27(31):5181-5188. doi: 10.3748/wjg.v27.i31.5181. World J Gastroenterol. 2021. PMID:34497443 Free PMC article. Review.
Cited by
-
Chronic Hepatitis C: Acute Exacerbation and Alanine Aminotransferase Flare.Viruses. 2023 Jan 8;15(1):183. doi: 10.3390/v15010183. Viruses. 2023. PMID:36680223 Free PMC article. Review.
-
Programmed Cell Death Protein 1 Axis Inhibition in Viral Infections: Clinical Data and Therapeutic Opportunities.Vaccines (Basel). 2022 Oct 7;10(10):1673. doi: 10.3390/vaccines10101673. Vaccines (Basel). 2022. PMID:36298538 Free PMC article. Review.
-
Hepatotoxicity during legacy cancer chemotherapy in patients infected with hepatitis C virus: A retrospective cohort study.Can Liver J. 2022 Feb 4;5(1):43-60. doi: 10.3138/canlivj-2021-0018. eCollection 2022 Winter. Can Liver J. 2022. PMID:35990784 Free PMC article.
-
A case of acute exacerbation of chronic hepatitis C during the course of adrenal Cushing's syndrome.Clin Case Rep. 2022 Feb 2;10(2):e05337. doi: 10.1002/ccr3.5337. eCollection 2022 Feb. Clin Case Rep. 2022. PMID:35140952 Free PMC article.
-
Management of hepatitis B and C in special population.World J Gastroenterol. 2021 Oct 28;27(40):6861-6873. doi: 10.3748/wjg.v27.i40.6861. World J Gastroenterol. 2021. PMID:34790011 Free PMC article. Review.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical