Ramsey SD, et al. - In this cohort study of 3,051 patients with newly diagnosed cancer, researchers investigated the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection. They noted infection rates of 6.5% for previous hepatitis B virus, 0.6% for chronic hepatitis B virus, 2.4% for hepatitis C virus, and 1.1% for HIV. The findings support screening patients with cancer to identify HBV and HCV infection prior to starting treatment to prevent viral reactivation and adverse clinical outcomes. Given a low rate of undiagnosed HIV infection, universal screening for HIV infection is not supported.

Methods

• Researchers conducted a multicenter prospective cohort study of patients with newly diagnosed cancer (ie, identified within 120 days of cancer diagnosis) at nine academic and nine community oncology institutions affiliated with SWOG (formerly the Southwest Oncology Group) Cancer Research Network, a member of the National Clinical Trials Network.
• The enrollment was done from August 29, 2013 through February 15, 2017.
• Using data available through August 17, 2017, they conducted data analysis.
• The presence of HBV infection (previous or chronic), HCV infection, or HIV infection at enrollment was the primary end point.
• They evaluated patients with previous knowledge of infection as well as patients with unknown viral status.

Results

• They identified 3,092 registered patients, of whom, 3,051 were eligible and evaluable; 1,842 (60.4%) were female, 553 (18.1%) were black, and 558 (18.3%) were Hispanic ethnicity.
• Clinical and demographic characteristics of the screened patients were similar to those of registered patients.
• Previous HBV infection was observed in 6.5% (95% CI, 5.6%-7.4%; n = 197 of 3,050 patients); chronic HBV in 0.6% (95% CI, 0.4%-1.0%; n = 19 of 3,050 patients); HCV in 2.4% (95% CI, 1.9%-3.0%; n = 71 of 2,990 patients); and HIV in 1.1% (95% CI, 0.8%-1.6%; n = 34 of 3,045).
• Diagnosis was newly made through the study in 8 patients with chronic HBV (42.1%; 95% CI, 20.3%-66.5%), 22 patients with HCV (31.0%; 95% CI, 20.5%-43.1%), and 2 patients with HIV (5.9%; 95% CI, 0.7%-19.7%) among those with viral infections.
• Among patients with infections, no identifiable risk factors were evident in four patients with chronic HBV (21.1%; 95% CI, 6.1%-45.6%), 23 patients with HCV (32.4%; 95% CI, 21.8%-44.5%), and 7 patients with HIV (20.6%; 95% CI, 8.7%-37.9%).