title: Hepatitis C virus screening in patients with cancer receiving chemotherapy.
abstract: OBJECTIVE
  Reactivation of hepatitis C virus (HCV) replication can occur in patients receiving immunosuppressive therapy. We aimed to determine the prevalence and predictors of HCV screening at the onset of chemotherapy among patients with cancer.
  
  
  METHODS
  We conducted a retrospective cohort study of adults with cancer who were newly registered at MD Anderson Cancer Center from January 2004 to April 2011 and received chemotherapy. The primary study outcome was HCV antibody (anti-HCV) screening at chemotherapy onset. We calculated screening prevalence and predictors by comparing characteristics of screened and unscreened patients using multivariable logistic regression.
  
  
  RESULTS
  A total of 141,877 new patients with cancer were registered at MD Anderson during the study period, of whom 16,773 (11.8%) received chemotherapy and met inclusion criteria. A total of 2,330 patients (13.9%) were screened for HCV, and 35 (1.5%) tested positive. Only 42% of patients with exposure-type HCV risk factors, such as HIV infection, injection drug use, hemodialysis, or hemophilia, were screened. Birth after 1965, Asian race, HCV risk factors, and anticipated rituximab therapy were significant predictors of HCV screening; black patients and patients with solid tumors were significantly less likely to be screened. The only significant predictor of a positive anti-HCV result was birth during 1945 to 1965.
  
  
  CONCLUSIONS
  HCV screening rates were low, even among patients with risk factors, and the groups with the highest rates of screening did not match the groups with the highest rates of a positive test result. Misconceptions may exist about which patients should be screened for HCV infection.
authors.affiliation: University of Texas MD Anderson Cancer Center; Baylor College of Medicine, Houston, TX; and University of Michigan, Ann Arbor, MI jphwang@mdanderson.org.
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Hwang
authors.affiliation: University of Texas MD Anderson Cancer Center; Baylor College of Medicine, Houston, TX; and University of Michigan, Ann Arbor, MI.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Suarez-Almazor
authors.affiliation: University of Texas MD Anderson Cancer Center; Baylor College of Medicine, Houston, TX; and University of Michigan, Ann Arbor, MI.
authors.forename: Harrys A
authors.initials: HA
authors.lastname: Torres
authors.affiliation: University of Texas MD Anderson Cancer Center; Baylor College of Medicine, Houston, TX; and University of Michigan, Ann Arbor, MI.
authors.forename: Shana L
authors.initials: SL
authors.lastname: Palla
authors.affiliation: University of Texas MD Anderson Cancer Center; Baylor College of Medicine, Houston, TX; and University of Michigan, Ann Arbor, MI.
authors.forename: Donna S
authors.initials: DS
authors.lastname: Huang
authors.affiliation: University of Texas MD Anderson Cancer Center; Baylor College of Medicine, Houston, TX; and University of Michigan, Ann Arbor, MI.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
authors.affiliation: University of Texas MD Anderson Cancer Center; Baylor College of Medicine, Houston, TX; and University of Michigan, Ann Arbor, MI.
authors.forename: Anna S F
authors.initials: AS
authors.lastname: Lok
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects* / Q000627:therapeutic use; D000914:Antibodies, Viral / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D008175:Lung Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D000069283:Rituximab; D014775:Virus Activation / Q000187:drug effects*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000914:Antibodies, Viral; D000970:Antineoplastic Agents; D000069283:Rituximab