Newly-diagnosed cancer patients may benefit from hepatitis screening

Last Updated: 2019-01-25

By David Douglas

NEW YORK (Reuters Health) - Universal testing for the hepatitis B and C viruses appears worthwhile in patients with newly diagnosed cancer, according to a multicenter study.

"As a cancer patient, or physician, I would want to know the results of a hepatitis screening test," Dr. Scott D. Ramsey told Reuters Health by email. "The presence of a potentially life-threatening infection could guide care in very important ways."

As reported January 17 online in JAMA Oncology, Dr. Ramsey of the Fred Hutchinson Cancer Research Center, Seattle and colleagues prospectively evaluated patients within 120 days of cancer diagnosis.

Between 2013 and 2017, more than 3000 patients with previous knowledge of infection as well as patients with unknown viral status were screened for HBV, HCV and HIV.

In all, 6.5% of patients had previous HBV, 0.6 percent had chronic HBV, 2.4% had HCV and 1.1% had HIV.

However, a substantial proportion of patients (87.3%) with past HBV infection were undiagnosed prior to the study screening. This was also the case for 42.1% of those with chronic HBV, and 31% of those with HCV.

Only two HIV infections (5.9%) were newly diagnosed by screening.

Dr. Ramsey concluded in a statement, "While our results don't suggest that universal HIV screening is necessary for cancer patients, they do provide new evidence to inform a discussion in the oncology community about whether we should require hepatitis screenings. Screening may be especially important now that we've entered the age of immunotherapies for cancer."

Dr. Ramsey and colleagues are currently analyzing results of a separate study to determine whether universal hepatitis and HIV screenings of cancer patients would be cost effective.

Commenting by email, Dr. Harrys A. Torres of the University of Texas MD Anderson Cancer Center, Houston, told Reuters Health that "all cancer patients, not only those with risk factors or liver cancer, should be screened for HBV and HCV because these infections can cause significant morbidity and mortality and interfere with cancer treatment."

Dr. Torres, who is founder and director of the HCV clinic at MD Anderson, added, "With the availability of nucleos(t)ide analogues to treat HBV and direct-acting antivirals to treat HCV, infected cancer patients can effectively and safely be treated to prevent viral reactivation, progression of the liver disease, and allow access to cancer treatment including clinical trials."

SOURCE: http://bit.ly/2Uegntd

JAMA Oncol 2019.