Harrys A Torres1, Parag Mahale2, Boris Blechacz1, Ethan Miller1, Ahmed Kaseb1, H Franklin Herlong1, Nathan Fowler1, Ying Jiang1, Issam I Raad1, Dimitrios P Kontoyiannis1. 1. From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas. From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Hepatitis C virus (HCV) infection is a neglected disease in patients with cancer. Therefore, this study examined the impact of HCV infections in these patients. METHODS: The records of HCV-infected patients with cancer seen at The University of Texas MD Anderson Cancer Center (2008-2011) were reviewed. The outcomes of those who underwent HCV treatment were analyzed. RESULTS: Of 1291 patients who had positive test results for an antibody to HCV (anti-HCV), 744 (58%) were tested for HCV-RNA; 642 (86%) of which had chronic HCV infections. Most had solid tumors (72%) and genotype-1 (G-1) infections (66%). HCV therapy was administered in 348 patients (98 of them after cancer diagnosis). Sustained virologic response (SVR) occurred in 27 (35%) of the 78 patients treated for whom outcome data were available. Compared with patients who experienced an SVR, more patients who did not were black (29% vs 4%; P=.007), had G-1 infections (72% vs 6%; P<.0001), and had higher baseline aspartate aminotransferase (78 vs 47 IU/L; P=.006) and alanine aminotransferase levels (71.1 vs 43.3 IU/L; P=.009). Overall, progression to cirrhosis (hazard ratio [HR], 0.38; P=.03) and portal hypertension (HR, 0.19; P=.009) was less common in those treated, irrespective of the treatment outcome (SVR or non-SVR). Hepatocellular carcinoma (HCC) developed as a second primary malignancy in 7% of patients with non-HCC cancer. CONCLUSIONS: This is the largest series to analyze HCV infections in patients with cancer. HCV therapy is feasible and prevents liver disease progression in this forgotten population. A treatment algorithm is provided.
BACKGROUND:Hepatitis C virus (HCV) infection is a neglected disease in patients with cancer. Therefore, this study examined the impact of HCV infections in these patients. METHODS: The records of HCV-infectedpatients with cancer seen at The University of Texas MD Anderson Cancer Center (2008-2011) were reviewed. The outcomes of those who underwent HCV treatment were analyzed. RESULTS: Of 1291 patients who had positive test results for an antibody to HCV (anti-HCV), 744 (58%) were tested for HCV-RNA; 642 (86%) of which had chronic HCV infections. Most had solid tumors (72%) and genotype-1 (G-1) infections (66%). HCV therapy was administered in 348 patients (98 of them after cancer diagnosis). Sustained virologic response (SVR) occurred in 27 (35%) of the 78 patients treated for whom outcome data were available. Compared with patients who experienced an SVR, more patients who did not were black (29% vs 4%; P=.007), had G-1 infections (72% vs 6%; P<.0001), and had higher baseline aspartate aminotransferase (78 vs 47 IU/L; P=.006) and alanine aminotransferase levels (71.1 vs 43.3 IU/L; P=.009). Overall, progression to cirrhosis (hazard ratio [HR], 0.38; P=.03) and portal hypertension (HR, 0.19; P=.009) was less common in those treated, irrespective of the treatment outcome (SVR or non-SVR). Hepatocellular carcinoma (HCC) developed as a second primary malignancy in 7% of patients with non-HCC cancer. CONCLUSIONS: This is the largest series to analyze HCV infections in patients with cancer. HCV therapy is feasible and prevents liver disease progression in this forgotten population. A treatment algorithm is provided.
Authors: M P Economides; P Mahale; A Kyvernitakis; F Turturro; H Kantarjian; A Naing; J Hosry; T L Shigle; A Kaseb; H A Torres Journal: Aliment Pharmacol Ther Date: 2016-10-11 Impact factor: 8.171
Authors: N T Oliver; Y L Nieto; B Blechacz; P Anderlini; E Ariza-Heredia; H A Torres Journal: Bone Marrow Transplant Date: 2016-07-18 Impact factor: 5.483
Authors: Andreas Kyvernitakis; Parag Mahale; Uday R Popat; Ying Jiang; Jeff Hosry; Richard E Champlin; Harrys A Torres Journal: Biol Blood Marrow Transplant Date: 2015-12-19 Impact factor: 5.742
Authors: Harrys A Torres; Terri Lynn Shigle; Nassim Hammoudi; James T Link; Felipe Samaniego; Ahmed Kaseb; Vincent Mallet Journal: CA Cancer J Clin Date: 2017-07-06 Impact factor: 508.702
Authors: Jeff Hosry; Parag Mahale; Francesco Turturro; Roberto N Miranda; Minas P Economides; Bruno P Granwehr; Harrys A Torres Journal: Int J Cancer Date: 2016-08-18 Impact factor: 7.396