Published online Mar 21, 2014. doi: 10.3748/wjg.v20.i11.2771
Revised: December 10, 2013
Accepted: January 6, 2014
Published online: March 21, 2014
Cancer patients have unique problems associated with hepatitis C virus (HCV) infection and treatment not seen in the general population. HCV infection poses additional challenges and considerations for the management of cancer, and vice versa. HCV infection also can lead to the development of cancer, particularly hepatocellular carcinoma and non-Hodgkin lymphoma. In severely immunocompromised cancer patients, diagnosis of HCV infection requires increased reliance on RNA detection techniques. HCV infection can affect chemotherapy, and delay of HCV infection treatment until completion of chemotherapy and achievement of cancer remission may be required to decrease the potential for drug-drug interactions between antineoplastic agents and HCV therapeutics and potentiation of side effects of these agents. In addition, hematopoietic stem cell transplant (HSCT) recipients have an increased risk of early development of cirrhosis and fibrosis. Whether this increased risk applies to all patients regardless of cancer treatment is unknown. Furthermore, patients with cancer may have poorer sustained virological responses to HCV infection treatment than do those without cancer. Unfortunately, not all cancer patients are candidates for HCV infection therapy. In this article, we review the challenges in managing HCV infection in cancer patients and HSCT recipients.
Core tip: Hepatitis C virus (HCV) infection adds complexity to treatment considerations of cancer patients. This is amplified by the absence of standard of care guidelines for the management of cancer patients with HCV infection. Not only can HCV infection result in the development hepatocellular cancer and non-Hodgkin lymphoma, but the presence of HCV infection in cancer patients can affect the treatment of malignancies with antineoplastic chemotherapies. Side effects of HCV therapy can be exacerbated in cancer patients due to underlying cytopenias and comorbidities. In those patients treated for HCV infection, cancer patients have poorer response to treatment than the general non-cancer population.