Reactivation of Hepatitis C Virus and Its Clinical Outcomes in Patients Treated with Systemic Chemotherapy or Immunosuppressive Therapy
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: According to the results of several studies, the outcome of hepatitis C virus (HCV) reactivation is not as severe as the outcome of hepatitis B virus reactivation. The aim of this study was to evaluate the effect of pharmacological immunosuppression on HCV reactivation. Methods: The medical records of patients who underwent systemic chemotherapy, corticosteroid therapy, or other immunosuppressive therapies between January 2008 and March 2015 were reviewed. Subsequently, 202 patients who were seropositive for the anti-HCV antibody were enrolled. Exclusion criteria were: unavailability of data on HCV RNA levels, a history of treatment for chronic hepatitis C, and the presence of liver diseases other than a chronic HCV infection. Results: Among the 120 patients enrolled in this study, hepatitis was present in 46 patients (38%). None of the patients were diagnosed with severe hepatitis. Enhanced replication of HCV was noted in nine (27%) of the 33 patients who had data available on both basal and follow-up HCV RNA loads. Reappearance of the HCV RNA from an undetectable state did not occur after treatment. The cumulative rate of enhanced HCV replication was 23% at 1 year and 30% at 2 years. Conclusions: Although enhanced HCV replication is relatively common in HCV-infected patients treated with chemotherapy or immunosuppressive therapy, it does not lead to serious sequelae.
Abstract
Background/Aims: According to the results of several studies, the outcome of hepatitis C virus (HCV) reactivation is not as severe as the outcome of hepatitis B virus reactivation. The aim of this study was to evaluate the effect of pharmacological immunosuppression on HCV reactivation. Methods: The medical records of patients who underwent systemic chemotherapy, corticosteroid therapy, or other immunosuppressive therapies between January 2008 and March 2015 were reviewed. Subsequently, 202 patients who were seropositive for the anti-HCV antibody were enrolled. Exclusion criteria were: unavailability of data on HCV RNA levels, a history of treatment for chronic hepatitis C, and the presence of liver diseases other than a chronic HCV infection. Results: Among the 120 patients enrolled in this study, hepatitis was present in 46 patients (38%). None of the patients were diagnosed with severe hepatitis. Enhanced replication of HCV was noted in nine (27%) of the 33 patients who had data available on both basal and follow-up HCV RNA loads. Reappearance of the HCV RNA from an undetectable state did not occur after treatment. The cumulative rate of enhanced HCV replication was 23% at 1 year and 30% at 2 years. Conclusions: Although enhanced HCV replication is relatively common in HCV-infected patients treated with chemotherapy or immunosuppressive therapy, it does not lead to serious sequelae.
참고문헌 (31)
- Boyer TD, "Zakim and Boyer’s hepatology", pp.2012, Saunders
- Seto WK, "Hepatitis B virus reactivation during immunosuppressive therapy: appropriate risk stratification", World J Hepatol, 7, pp.825~830 (2015)
- Torres HA, "Reactivation of hepatitis B virus and hepatitis C virus in patients with cancer", Nat Rev Clin Oncol, 9, pp.156~166 (2012)
- Watanabe T, "Reactivation of hepatitis viruses following immunomodulating systemic chemotherapy", Hepatol Res, 43, pp.113~121 (2013)
- Jang JW, "Reactivation of hepatitis B virus in HBsAg-negative patients with hepatocellular carcinoma", PLoS One, 10, pp.e0122041~ (2015)
- 성필수, "Differences in the patterns and outcomes of enhanced viral replication between hepatitis C virus and hepatitis B virus in patients with hepatocellular carcinoma during transarterial chemolipiodolization", Clinical and Molecular Hepatology, 17(4), pp.299~306 (2011), 대한간학회
- Mahale P, "Acute exacerbation and reactivation of chronic hepatitis C virus infection in cancer patients", J Hepatol, 57, pp.1177~1185 (2012)
- Zuckerman E, "Liver dysfunction in patients infected with hepatitis C virus undergoing chemotherapy for hematologic malignancies", Cancer, 83, pp.1224~1230 (1998)
- Jang JW, "Transarterial chemo-lipiodolization can reactivate hepatitis B virus replication in patients with hepatocellular carcinoma", J Hepatol, 41, pp.427~435 (2004)
- Ramírez S, "Virology and pathogenesis of hepatitis C virus recurrence", Liver Transpl, 14(Suppl 2), pp.S27~S35 (2008)
- Kawatani T, "Incidence of hepatitis virus infection and severe liver dysfunction in patients receiving chemotherapy for hematologic malignancies", Eur J Haematol, 67, pp.45~50 (2001)
- Vento S, "Reactivation of replication of hepatitis B and C viruses after immunosuppressive therapy: an unresolved issue", Lancet Oncol, 3, pp.333~340 (2002)
- Morrow PK, "Effects of chronic hepatitis C infection on the treatment of breast cancer patients", Ann Oncol, 21, pp.1233~1236 (2010)
- Ennishi D, "Hepatic toxicity and prognosis in hepatitis C virus-infected patients with diffuse large B-cell lymphoma treated with rituximab-containing chemotherapy regimens: a Japanese multicenter analysis", Blood, 116, pp.5119~5125 (2010)
- Hiraga N, "Clinical and virological characteristics of untreated patients with chronic hepatitis C who develop serum alanine aminotransferase flare-up", J Med Virol, 75, pp.240~248 (2005)
- Rumi MG, "Hepatitis C reactivation in patients with chronic infection with genotypes 1b and 2c: a retrospective cohort study of 206 untreated patients", Gut, 54, pp.402~406 (2005)
- Sheen IS, "Acute exacerbations in chronic hepatitis C: a clinicopathological and prognostic study", J Hepatol, 24, pp.525~531 (1996)
- Tsuji K, "Risk of alanine aminotransferase flare-up among asymptomatic hepatitis C virus RNA carriers: a 10-year follow-up study", J Gastroenterol Hepatol, 16, pp.536~540 (2001)
- Kneeman JM, "Secondary causes of nonalcoholic fatty liver disease", Therap Adv Gastroenterol, 5, pp.199~207 (2012)
- Ferraro D, "Methylprednisolone-induced toxic hepatitis after intravenous pulsed therapy for multiple sclerosis relapses", Neurologist, 19, pp.153~154 (2015)
- Caster O, "Methylprednisolone-induced hepatotoxicity: experiences from global adverse drug reaction surveillance", Eur J Clin Pharmacol, 70, pp.501~503 (2014)
- Nosotti L, "Hepatitis C virus infection prevalence and liver dysfunction in a cohort of B-cell non-Hodgkin’s lymphoma patients treated with immunochemotherapy", Scand J Infect Dis, 44, pp.70~73 (2012)
- Ferri C, "Safety of anti-tumor necrosis factor-alpha therapy in patients with rheumatoid arthritis and chronic hepatitis C virus infection", J Rheumatol, 35, pp.1944~1949 (2008)
- Li S, "Use of tumor necrosis factor-alpha (TNF-alpha) antagonists infliximab, etanercept, and adalimumab in patients with concurrent rheumatoid arthritis and hepatitis B or hepatitis C: a retrospective record review of 11 patients", Clin Rheumatol, 28, pp.787~791 (2009)
- Foran JM, "Hepatitis C in the rituximab era", Blood, 116, pp.5081~5082 (2010)
- Fong TL, "Short-term prednisone therapy affects aminotransferase activity and hepatitis C virus RNA levels in chronic hepatitis C", Gastroenterology, 107, pp.196~199 (1994)
- Vento S, "Fulminant hepatitis on withdrawal of chemotherapy in carriers of hepatitis C virus", Lancet, 347, pp.92~93 (1996)
- Doi H, "Dysfunctional B-cell activation in cirrhosis resulting from hepatitis C infection associated with disappearance of CD27-positive B-cell population", Hepatology, 55, pp.709~719 (2012)
- Chu CJ, "Hepatitis B virus", hepatitis C virus coinfection: epidemiology, clinical features, viral interactions and treatment, 2008, pp.23, 512~520
- Burgess S, "Drug interactions with direct-acting antivirals for hepatitis C: implications for HIV and transplant patients", Ann Pharmacother, 49, pp.674~687 (2015)
- Economides MP, "Concomitant use of direct-acting antivirals and chemotherapy in hepatitis C virus-infected patients with cancer", Aliment Pharmacol Ther, 44, pp.1235~1241 (2016)