CD4+ T-cell count was not predictive of treatment outcomes among patients with cancer who received direct-acting antivirals (DAAs) for Hepatitis C virus (HCV) infection, according to a prospective observational study published in Diagnostic Microbiology & Infectious Disease.

Investigators sought to determine the predictive value of CD4+ T-cells among patients with cancer receiving DAA treatment for HCV infection. Patients’ CD4+ T-cell count was measured at baseline, at the end of DAA treatment, and at 12 weeks after DAA treatment completion. Univariate and multivariate analyses were performed to determine the association between CD4+ T-cell count and achievement of a sustained virologic response 12 weeks after completion of DAA treatment.

Among a total of 174 patients included in the analysis, 70% were men, 60% were nonHispanic White, 82% received DAA therapy without ribavirin, and the median age was 61 years. In addition, 36 (20.6%) patients had hepatocellular carcinoma (HCC), and the most common hematologic malignancy was non-Hodgkin lymphoma in 31 (18%) patients. At baseline, 62 (36%) patients had cirrhosis and 5 had a CD4+ T-cell count of less than 100/µL.


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Twelve weeks after completion of DAA treatment, most patients (89%) had achieved a sustained virologic response. The multivariate logistic regression model showed that treatment failure was significantly associated with HCC (odds ratio [OR], 4; 95% CI, 4.47-44.29; P <.0001), HCV genotype 3 (HCV-3) infection (OR, 3.99; 95% CI, 1.02-15.64; P =.047), and history of DAA treatment (OR, 4.12; 95% CI, 1.31-12.99; P =.015). Of note, 15 (79%) patients who experienced DAA treatment failure had cirrhosis.

Neither the univariate nor multivariate analyses showed an association between CD4+ T-cell count measurements and sustained virologic response achievement at 12 weeks following DAA treatment.

This study was limited by its small sample size, as well as variations in cancer types and DAA regimens among the patient population.

“Our results highlight the importance of cirrhosis, HCV-3, HCC, and history of DAA treatment as predictors for treatment failures after DAA therapy in patients [with cancer and HCV infection],” the researchers concluded.

Disclosure: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. 

Reference

Angelidakis G, Pritchard H, Yibrin M, Jiang Y, Mustafayev K, Torres HA. Impact of CD4+ T-cell count on sustained virologic response to direct-acting antivirals in hepatitis C virus monoinfected cancer patients: A prospective observational study. Diagn Microbiol Infect Dis. Published online April 28, 2022. doi:10.1016/j.diagmicrobio.2022.115719