Hepatitis C virus screening in patients with cancer receiving chemotherapy

J Oncol Pract. 2014 May;10(3):e167-74. doi: 10.1200/JOP.2013.001215. Epub 2014 Mar 4.


Purpose: Reactivation of hepatitis C virus (HCV) replication can occur in patients receiving immunosuppressive therapy. We aimed to determine the prevalence and predictors of HCV screening at the onset 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 chemotherapy. The primary study outcome was HCV antibody (anti-HCV) screening at chemotherapy onset. We calculated screening prevalence 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 criteria. A total of 2,330 patients (13.9%) were screened for HCV, and 35 (1.5%) tested positive. Only 42% of patients with exposure-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 rituximab 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 patients 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 patients should be screened for HCV infection.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Murine-Derived / adverse effects*
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antibodies, Viral / blood
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / immunology
  • Breast Neoplasms / virology
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / immunology
  • Colorectal Neoplasms / virology
  • Female
  • Hepacivirus / immunology*
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / epidemiology
  • Hepatitis C, Chronic / immunology*
  • Humans
  • Immunocompromised Host
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / immunology
  • Lung Neoplasms / virology
  • Male
  • Mass Screening
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Rituximab
  • Virus Activation / drug effects*


  • Antibodies, Monoclonal, Murine-Derived
  • Antibodies, Viral
  • Antineoplastic Agents
  • Rituximab