Comorbid Hepatitis B, Hepatitis C in New Cancer Patients Often Undetected

Empty blood test tubes
Empty blood test tubes
Researchers suggest screening patients newly diagnosed with cancer for hepatitis B and hepatitis C virus, especially when it is cost-effective.

A significant number of patients with newly-diagnosed cancer and concurrent hepatitis B virus (HBV) or hepatitis C virus (HCV) infection are unaware of their viral infection at the time of cancer diagnosis, according to study results published in JAMA Oncology.

The results indicate that screening patients with cancer for HBV and HCV infection may help prevent viral reactivation and adverse clinical outcomes. The results did not, however, support screening patients with cancer for HIV, as the rate of patients with undiagnosed HIV was low.

The study included participants with newly diagnosed cancer at 9 academic and 9 community oncology institutions (n=3051). Participants were enrolled within 120 days of cancer diagnosis from August 29, 2013 through February 15, 2017. The primary end point was the presence of HBV infection (previous or chronic), HCV infection, or HIV infection at time of enrollment.

The median participant age was 60.6 (range 18.2 to 93.7); 60.4% were women (n=1842), 18.1% were black (n=553), and 18.3% were Hispanic (n=558).

Upon enrollment, the researchers found an observed infection rate of 6.5% (n=197 of 3050) for previous HBV infection, 0.6% (n=19 of 3050) for chronic HBV infection, 2.4% (n=71 of 2990) for HCV, and 1.1% (n=34 of 3045) for HIV. In participants with identified viral infections, 8 (42.1%) with chronic HBV, 22 (31.0%) with HCV, and 2 (5.9%) with HIV were newly diagnosed through the study. In addition, 4 participants (21.1%) with chronic HBV, 23 (32.4%) with HCV, and 7 (20.6%) with HIV had no identifiable risk factors.

“We believe our results warrant consideration of universal testing of patients with newly diagnosed cancer for HBV and HCV infection, particularly if such an approach is shown to be cost-effective,” the researchers wrote.

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Ramsey SD, Unger JM, Baker LH, et al. Prevalence of hepatitis B virus, hepatitis C virus, and HIV infection among patients with newly diagnosed cancer from academic and community oncology practices. [published online January 17, 2019]. JAMA Oncol. doi:10.1001/jamaoncol.2018.6437