Original Contribution Hepatitis C Virus Screening in Patients With Cancer Receiving Chemotherapy

Purpose: Reactivation of hepatitis C virus (HCV) replication can occur in patients receiving immunosuppressive therapy. We aimed to determine theprevalenceandpredictorsofHCVscreeningat theonset of chemotherapy among patients with cancer. Methods: We conducted a retrospective cohort study of adults with cancer who were newly registered at MD Anderson Cancer Center from January 2004 to April 2011 and received chemother-apy. The primary study outcome was HCV antibody (anti-HCV) screening at chemotherapy onset. We calculated screening preva-lence and predictors by comparing characteristics of screened and unscreened patients using multivariable logistic regression. Results: A total of 141,877 new patients with cancer were registered at MD Anderson during the study period, of whom 16,773 (11.8%) received chemotherapy and met inclusion cri-teria. A total of 2,330 patients (13.9%) were screened for HCV, and 35 (1.5%) tested positive. Only 42 % of patients with ex-posure-type HCV risk factors, such as HIV infection, injection drug use, hemodialysis, or hemophilia, were screened. Birth after 1965, Asian race, HCV risk factors, and anticipated ritux-imab therapy were significant predictors of HCV screening; black patients and patients with solid tumors were significantly less likely to be screened. The only significant predictor of a positive anti-HCV result was birth during 1945 to 1965. Conclusion: HCV screening rates were low, even among pa-tients with risk factors, and the groups with the highest rates of screening did not match the groups with the highest rates of a positive test result. Misconceptions may exist about which pa-tients should be screened for HCV infection