Treatment of Acute Hepatitis C With Ledipasvir and Sofosbuvir in Patients With Hematological Malignancies Allows Early Re-start of Chemotherapy

Brancaccio, Giuseppina; Sorbo, M.C.; Frigeri, Ferdinando; Rizzo, Viviana; Cantone, Marco; Genderini, Francesco; Fabeni, Lavinia; Pinto, Antonio; Perno, Carlo Federico; Ceccherini‐Silberstein, Francesca; Gaeta, Giovanni Battista

doi:10.1016/j.cgh.2017.10.032

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…However, it can affect cancer treatment decisions . In fact, given the dangerous effects of viral reactivation that can occur in HBV‐patients, oncologists often reduce or discontinue antineoplastic therapies in HCV‐infected patients for fear of similar harmful consequences . This was recently demonstrated by Torres and colleagues in a study in which they found, that although HCV reactivation (which occurred in about 25% of cases during chemotherapy) had a benign course, it influenced the antineoplastic regimens in terms of under‐dosage or premature interruptions, and thus adversely affected cancer outcome.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded by suggesting DAAs be used concomitantly with antineoplastic therapy to avoid such negative consequences . Similarly, Brancaccio et al reported that acute HCV hepatitis in a small cohort of patients with onco‐haematological diseases led to the suspension or under‐dosing of the antineoplastic treatment, and that immediate antiviral treatment with DAAs enabled rapid re‐introduction of chemotherapy . Finally, due to the risk of reactivation, HCV infection is often an exclusion criterion in experimental protocols with innovative chemotherapies …”

Section: Discussionmentioning

confidence: 99%

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Hepatitis C virus infection and non‐hepatocellular malignancies in the DAA era: A systematic review and meta‐analysis

Masarone

Persico

2019

Liver International

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Background and Aims: Direct antiviral agents have greatly improved therapeutic options for chronic hepatitis C. Indeed, former "difficult-to-treat" patients can now be treated and can achieve sustained response. Hepatitis C virus (HCV) is associated with hepatocellular carcinoma and with B-cell non-Hodgkin lymphoma (B-NHL).Other malignancies have been reported to be associated with HCV infection albeit with various grades of evidence. Antineoplastic treatment is often reduced or suspended in HCV-positive cancer patients to avoid "HCV reactivation." In this setting, antiviral therapy combined with antineoplastic protocols may improve the outcome.For this reason, we conducted a systematic review and a meta-analysis to update the association between HCV infection and non-hepatocellular malignancies, and to shed light on the effects exerted by antiviral treatment on the natural history of oncological diseases.Methods: Relevant studies were identified by searching PUBMED, EMBASE and MEDLINE up to 1 August 2018. Pooled risk estimates were calculated with randomeffects models according to PRISMA guidelines. Results:A total of 58 studies were included in the analysis: 27 studies of the association between HCV and B-NHL(OR 3.36; 95% CI 2.40-4.72;P < 0.00001);13 studies of the association between sustained virological response and progression-free survival (PFS) in B-NHL patients (OR 9.34;; P < 0.00001); 13 studies of the association between HCV and intrahepatic-cholangio-carcinoma (OR 3.95;95% CI 2.25-6.94; P < 0.00001); and 5 studies of the association between HCV infection and pancreatic adeno-carcinoma(OR 1.60; 95% CI:1.25-2.04; P = 0.0002). Conclusions:This study updates the strong association between B-NHL and HCV infection, confirms the association between HCV and non-hepatocellular tumours, and demonstrates a very strong association between viral eradication and a better outcome of HCV-positive B-NHL. K E Y W O R D S direct antiviral agents, HCV antiviral therapy, metanalysis, non-hepatocellular cancer, non-Hodgkin lymphoma | 1293 MASARONE Et Al.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatitis C virus infection and non‐hepatocellular malignancies in the DAA era: A systematic review and meta‐analysis

Masarone

Persico

2019

Liver International

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“…The six patients with hematological malignances received a diagnosis of de-novo acute HCV infection between January and February 2016. None of these patients had developed anti-HCV antibodies (also at the last follow-up visit), confirming their profound immunodepression state as a result of the disease and the chemotherapy received [36]. All subjects gave their informed consent for inclusion before they participated in the study.…”

Section: Methodsmentioning

confidence: 93%

“…All the patients were naïve to DAAs, with the exception of 1 patient with chronic infection who failed a DAA based regimen. Twenty-two patients were affected by β-thalassemia Major and 6 patients had an onco-hematologic disease [31,36]. Eleven β-thalassemia patients received a diagnosis of acute HCV infection during an outbreak between April and November 2016.…”

Section: Methodsmentioning

confidence: 99%

“…By performing phylogenetic analysis on NS3, NS5A and NS5B genes using Sanger sequencing, we recently identified separate episodes of HCV transmission in two healthcare settings: one in patients with acute HCV diagnosis affected by onco-hematologic disease [36] and the second in patients with acute HCV diagnosis with β-thalassemia [31]. In this present study, through NS5A NGS analysis we aimed to investigate the intra-host viral quasispecies composition and resistance transmission in 15 patients, all putatively involved in transmission clusters.…”

Section: Introductionmentioning

confidence: 99%

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NS5A Gene Analysis by Next Generation Sequencing in HCV Nosocomial Transmission Clusters of HCV Genotype 1b Infected Patients

Bellocchi

Aragri

Carioti

et al. 2019

Cells

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Background: The aim of the study was to investigate the intra-host variability through next-generation-sequencing (NGS) of the NS5A-gene in nosocomial transmission-clusters observed in two Italian hospitals among hepatitis C virus (HCV)-genotype-1b infected patients. Methods: HCV-sequencing was performed by Sanger-sequencing (NS3 + NS5A + NS5B) and by NGS (NS5A, MiSeq-Illumina) in 15 HCV-1b infected patients [five acute with onco-hematologic-disease and 10 (4/6 acute/chronic) with β-thalassemia]. Resistance-associated-substitutions (RAS) were analysed by Geno2pheno-algorithm. Nucleotide-sequence-variability (NSV, at 1%, 2%, 5%, 10% and 15% NGS-cutoffs) and Shannon entropy were estimated. Phylogenetic analysis was performed by Mega6-software and Bayesian-analysis. Results: Phylogenetic analysis showed five transmission-clusters: one involving four HCV-acute onco-hematologic-patients; one involving three HCV-chronic β-thalassemia-patients and three involving both HCV-acute and chronic β-thalassemia-patients. The NS5A-RAS Y93H was found in seven patients, distributed differently among chronic/acute patients involved in the same transmission-clusters, independently from the host-genetic IL-28-polymorphism. The intra-host NSV was higher in chronic-patients versus acute-patients, at all cutoffs analyzed (p < 0.05). Even though Shannon-entropy was higher in chronic-patients, significantly higher values were observed only in chronic β-thalassemia-patients versus acute β-thalassemia-patients (p = 0.01). Conclusions: In nosocomial HCV transmission-clusters, the intra-host HCV quasispecies divergence in patients with acute-infection was very low in comparison to that in chronic-infection. The NS5A-RAS Y93H was often transmitted and distributed differently within the same transmission-clusters, independently from the IL-28-polymorphism.

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Acute hepatitis C: treat immediately or give a chance to spontaneously clear?

Kaplan¹

2020

Clinical Dilemmas in Viral Liver Disease

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Treatment of Acute Hepatitis C With Ledipasvir and Sofosbuvir in Patients With Hematological Malignancies Allows Early Re-start of Chemotherapy

Cited by 12 publications

References 7 publications

Hepatitis C virus infection and non‐hepatocellular malignancies in the DAA era: A systematic review and meta‐analysis

Hepatitis C virus infection and non‐hepatocellular malignancies in the DAA era: A systematic review and meta‐analysis

NS5A Gene Analysis by Next Generation Sequencing in HCV Nosocomial Transmission Clusters of HCV Genotype 1b Infected Patients

Acute hepatitis C: treat immediately or give a chance to spontaneously clear?

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