TY - JOUR
T1 - Strategies to identify hepatitis C virus infection in patients receiving anticancer therapy
T2 - a cross-sectional study
AU - Torres, Harrys A.
AU - Lok, Anna S.
AU - Suarez-Almazor, Maria E.
AU - Warneke, Carla L.
AU - Kaseb, Ahmed
AU - Miller, Ethan
AU - Sturgis, Erich M.
AU - Foreman, Jessica T.
AU - Angelidakis, Georgios
AU - Ahmed, Sairah
AU - Ferrajoli, Alessandra
AU - Samaniego, Felipe
AU - Hawk, Ernest T.
AU - Hwang, Jessica P.
N1 - Funding Information:
We acknowledge Cynthia Jorgensen at the Centers for Disease Control and Prevention for assistance with the hepatitis risk survey; Rhodrick Haralson, Sheila Khalili-Ahmadi, and Dianne Stryk for assistance with patient enrollment; Reeni Luke and Sanjivkumar Dave for guidance with institutional databases; Jean Caputo and Calvin Harris for help with survey development; Stephanie Deming for editorial assistance; and Laurissa Gann for assistance with references. We are grateful to the study patients who generously gave their time and effort to this project.
Funding Information:
Supported by the National Cancer Institute [K07CA132955 to Hwang, R21CA167202 to Hwang, and P30CA016672 (MD Anderson Cancer Center Clinical Trials Support Resource)]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Acknowledgements
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/1
Y1 - 2021/1
N2 - Background: Optimal hepatitis C virus (HCV) screening strategies for cancer patients have not been established. We compared the performance of selective HCV screening strategies. Methods: We surveyed patients presenting for first systemic anticancer therapy during 2013–2014 for HCV risk factors. We estimated the prevalence of positivity for HCV antibody (anti-HCV) and examined factors associated with anti-HCV status using Fisher’s exact test or Student’s t test. Sensitivity was calculated for screening patients born during 1945–1965, patients with ≥ 1 other risk factor, or both cohorts (“combined screening”). Results: We enrolled 2122 participants. Median age was 59 years (range, 18–91); 1138 participants were women. Race/ethnicity distribution was white non-Hispanic, 76% (n = 1616); Hispanic, 11% (n = 233); black non-Hispanic, 8% (n = 160); Asian, 4% (n = 78); and other, 2% (n = 35). Primary cancer distribution was non-liver solid tumor, 78% (n = 1664); hematologic cancer, 20% (n = 422); and liver cancer, 1% (n = 28). Prevalence of anti-HCV was 1.93% (95% CI, 1.39%–2.61%). Over 28% of patients with detectable HCV RNA were unaware of infection. Factors significantly associated with anti-HCV positivity included less than a bachelor’s degree, birth in 1945–1965, chronic liver disease, injection drug use, and blood transfusion or organ transplant before 1992. A total of 1315 participants (62%), including 39 of 41 with anti-HCV, reported ≥ 1 risk factor. Sensitivity was 80% (95% CI, 65–91%) for birth-cohort-based, 68% (95% CI, 52–82%) for other-risk-factor-based, and 95% (95% 83–99%) for combined screening. Conclusion: Combined screening still missed 5% of patients with anti-HCV. These findings favor universal HCV screening to identify all HCV-infected cancer patients.
AB - Background: Optimal hepatitis C virus (HCV) screening strategies for cancer patients have not been established. We compared the performance of selective HCV screening strategies. Methods: We surveyed patients presenting for first systemic anticancer therapy during 2013–2014 for HCV risk factors. We estimated the prevalence of positivity for HCV antibody (anti-HCV) and examined factors associated with anti-HCV status using Fisher’s exact test or Student’s t test. Sensitivity was calculated for screening patients born during 1945–1965, patients with ≥ 1 other risk factor, or both cohorts (“combined screening”). Results: We enrolled 2122 participants. Median age was 59 years (range, 18–91); 1138 participants were women. Race/ethnicity distribution was white non-Hispanic, 76% (n = 1616); Hispanic, 11% (n = 233); black non-Hispanic, 8% (n = 160); Asian, 4% (n = 78); and other, 2% (n = 35). Primary cancer distribution was non-liver solid tumor, 78% (n = 1664); hematologic cancer, 20% (n = 422); and liver cancer, 1% (n = 28). Prevalence of anti-HCV was 1.93% (95% CI, 1.39%–2.61%). Over 28% of patients with detectable HCV RNA were unaware of infection. Factors significantly associated with anti-HCV positivity included less than a bachelor’s degree, birth in 1945–1965, chronic liver disease, injection drug use, and blood transfusion or organ transplant before 1992. A total of 1315 participants (62%), including 39 of 41 with anti-HCV, reported ≥ 1 risk factor. Sensitivity was 80% (95% CI, 65–91%) for birth-cohort-based, 68% (95% CI, 52–82%) for other-risk-factor-based, and 95% (95% 83–99%) for combined screening. Conclusion: Combined screening still missed 5% of patients with anti-HCV. These findings favor universal HCV screening to identify all HCV-infected cancer patients.
KW - Drug therapy
KW - Hepatitis C virus
KW - Neoplasms
KW - Virus activation
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U2 - 10.1007/s00520-020-05456-3
DO - 10.1007/s00520-020-05456-3
M3 - Article
C2 - 32314052
AN - SCOPUS:85084047643
SN - 0941-4355
VL - 29
SP - 97
EP - 105
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 1
ER -