Hepatitis C virus acute exacerbation during chemotherapy and radiotherapy for oesophageal carcinoma

Pree, C. de; Giostra, Emiliano; Galetto, Annick; Perrin, Luc; Zulian, Gilbert

doi:10.1093/oxfordjournals.annonc.a059022

Cited by 20 publications

(14 citation statements)

References 8 publications

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“…Several studies have indicated that systemic chemotherapy for a variety of solid tumors or lymphoma can lead to worsening of viral hepatitis (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Lok and colleagues found that sudden increases in or reactivation of HBV replication occurred in two-thirds of patients who were HBV surface antigen positive and treated with cytotoxic chemotherapy for lymphoma, leading to jaundice in 22% of patients and hepatic failure in 4% (13).…”

Section: Discussionmentioning

confidence: 99%

“…The situation with HCV is less well established. There are case reports that HCV viral replication can be increased by chemotherapy and hepatitis worsened during treatment of esophageal cancer (15), and fulminant hepatitis has been described after withdrawal of chemotherapy in lymphoma patients (16). However, in a recent series of 33 patients with HCV infection and a variety of hematological malignancies, only 1 patient had a significant rise in ALT, and there were no cases of fulminant hepatitis (17).…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have indicated that viral hepatitis can be reactivated during treatment of several tumors using systemic chemotherapy, with elevated serum levels of hepatitis B DNA or hepatitis C RNA, increased liver injury tests, and, occasionally, fulminant hepatic failure (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). The mechanism is thought to reflect chemotherapyinduced immunosuppression.…”

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confidence: 99%

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The Effects of Hepatic Artery Chemotherapy on Viral Hepatitis in Patients With Hepatocellular Carcinoma

2005

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Transcatheter arterial chemoembolization (TACE) or arterial Yttrium-90 (90Y) microspheres are used to treat unresectable hepatocellular carcinoma (HCC), but little is known about their effects on viral hepatitis. The aim of this study was to determine their effect on viral hepatitis in patients with HCC. We carried out a retrospective review of patients treated for HCC. Worsening of viral hepatitis was determined by serum chemistry and viral loads where available. Fifty-two patients treated with TACE were followed for a mean of 22.0 months. Thirty-nine patients (75%) had decreased/stable tumor. Two of the 39 (5%) patients with decreased/stable tumor burden had a sustained increase in bilirubin. None had a sustained ALT elevation or significant increase in viral load after TACE. Twenty-four patients treated with 90Y microspheres were followed for a mean of 12.0 months. Twenty-two of these had a decreased/stable tumor burden and no patient had a significant elevation of ALT. However, 7 of the 22 had a sustained bilirubin elevation. We conclude that neither TACE nor 90Y treatment was associated with worsening viral hepatitis in this group of HCC patients. The presence of chronic viral hepatitis with normal bilirubin should not exclude the use of these therapies in patients with unresectable HCC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The Effects of Hepatic Artery Chemotherapy on Viral Hepatitis in Patients With Hepatocellular Carcinoma

2005

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“…64,68,72 HCV is a risk factor for drug-induced liver injury from some drugs, and there are case reports of increased viral titers and more severe HCV infection after recovery of immunity following immunosuppressive chemotherapy. 30,73,74 A cirrhotic patient would be at greater risk than someone without cirrhosis for worsening HCV-related liver inflammation. Treatment of HCVinfected cirrhotic patients with DAAs can be successful in achieving an SVR, but should probably be deferred until the course of hematologic malignancy is clear.…”

Section: Summary Casementioning

confidence: 99%

How I treat hepatitis C virus infection in patients with hematologic malignancies

Torres

McDonald

2016

Blood

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Hepatitis C virus (HCV) infection is not uncommon in cancer patients. Over the past 5 years, treatment of chronic HCV infection in patients with hematologic malignancies has evolved rapidly as safe and effective direct-acting antivirals (DAAs) have become the standard-of-care treatment. Today, chronic HCV infection should not prevent a patient from receiving cancer therapy or participating in clinical trials of chemotherapy because most infected patients can achieve virologic cure. Elimination of HCV from infected cancer patients confers virologic, hepatic, and oncologic advantages. Similar to the optimal therapy for HCV-infected patients without cancer, the optimal therapy for HCV-infected patients with cancer is evolving rapidly. The choice of regimens with DAAs should be individualized after thorough assessment for potential hematologic toxic effects and drug-drug interactions. This study presents clinical scenarios of HCV-infected patients with hematologic malignancies, focusing on diagnosis, clinical and laboratory presentations, complications, and DAA therapy. An up-to-date treatment algorithm is presented.

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“…However reactivation has been reported to occur more frequently in patients with hematological malignancies 392,397. HCV reactivation has also been reported in patients with solid cancer or stem cell transplantation 398,399,400,401. Although death due to HCV reactivation has rarely been documented,402 the mortality is similar to that of HBV once severe hepatitis occurs with HCV reactivation 403,404,405…”

Section: Patients Receiving Immunosuppressants or Cytotoxic Chemotherapymentioning

confidence: 99%

KASL clinical practice guidelines: Management of Hepatitis C

2014

Clin Mol Hepatol

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Hepatitis C virus acute exacerbation during chemotherapy and radiotherapy for oesophageal carcinoma

Cited by 20 publications

References 8 publications

The Effects of Hepatic Artery Chemotherapy on Viral Hepatitis in Patients With Hepatocellular Carcinoma

The Effects of Hepatic Artery Chemotherapy on Viral Hepatitis in Patients With Hepatocellular Carcinoma

How I treat hepatitis C virus infection in patients with hematologic malignancies

KASL clinical practice guidelines: Management of Hepatitis C

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