title: Effect of hepatitis C virus infection in patients with cancer: addressing a neglected population.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection is a neglected disease in patients with cancer. Therefore, this study examined the impact of HCV infections in these patients.
  
  
  METHODS
  The records of HCV-infected patients with cancer seen at The University of Texas MD Anderson Cancer Center (2008-2011) were reviewed. The outcomes of those who underwent HCV treatment were analyzed.
  
  
  RESULTS
  Of 1291 patients who had positive test results for an antibody to HCV (anti-HCV), 744 (58%) were tested for HCV-RNA; 642 (86%) of which had chronic HCV infections. Most had solid tumors (72%) and genotype-1 (G-1) infections (66%). HCV therapy was administered in 348 patients (98 of them after cancer diagnosis). Sustained virologic response (SVR) occurred in 27 (35%) of the 78 patients treated for whom outcome data were available. Compared with patients who experienced an SVR, more patients who did not were black (29% vs 4%; P=.007), had G-1 infections (72% vs 6%; P<.0001), and had higher baseline aspartate aminotransferase (78 vs 47 IU/L; P=.006) and alanine aminotransferase levels (71.1 vs 43.3 IU/L; P=.009). Overall, progression to cirrhosis (hazard ratio [HR], 0.38; P=.03) and portal hypertension (HR, 0.19; P=.009) was less common in those treated, irrespective of the treatment outcome (SVR or non-SVR). Hepatocellular carcinoma (HCC) developed as a second primary malignancy in 7% of patients with non-HCC cancer.
  
  
  CONCLUSIONS
  This is the largest series to analyze HCV infections in patients with cancer. HCV therapy is feasible and prevents liver disease progression in this forgotten population. A treatment algorithm is provided.
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Harrys A
authors.initials: HA
authors.lastname: Torres
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas. From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Parag
authors.initials: P
authors.lastname: Mahale
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Boris
authors.initials: B
authors.lastname: Blechacz
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ethan
authors.initials: E
authors.lastname: Miller
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Kaseb
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: H Franklin
authors.initials: HF
authors.lastname: Herlong
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Nathan
authors.initials: N
authors.lastname: Fowler
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Issam I
authors.initials: II
authors.lastname: Raad
authors.affiliation: From the Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center; The University of Texas School of Public Health; and the Departments of Gastroenterology, Hepatology and Nutrition, Gastrointestinal Medical Oncology, and Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Kontoyiannis
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001706:Biopsy; D060085:Coinfection; D018450:Disease Progression; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D019698:Hepatitis C, Chronic; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000209:etiology; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents