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Harrys A. Torres, Parag Mahale, Boris Blechacz, Ethan Miller, Ahmed Kaseb, H. Franklin Herlong, Nathan Fowler, Ying Jiang, Issam I. Raad, and Dimitrios P. Kontoyiannis

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.

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Harrys A. Torres, Lillian R. Roach, Parag Mahale, Minas P. Economides, Boris Blechacz, Ethan Miller, Roy Borchardt, Anis Rashid, Thein H. Oo, Bhavarth Shukla, Malik Farida, Charles D. Ericsson, Bruno P. Granwehr, and Issam I. Raad