癌症合并病毒感染患者的抗病毒治疗使用情况及相关结局：SWOG S1204 研究结果。

Antiviral therapy use and related outcomes in patients with cancer and viral infections: results from SWOG S1204.

机构信息

Department of General Internal Medicine, Unit 1465, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230-1402, USA.

SWOG Statistics and Data Management Center, Seattle, WA, USA.

出版信息

Support Care Cancer. 2022 Dec 31;31(1):93. doi: 10.1007/s00520-022-07525-1.

DOI:10.1007/s00520-022-07525-1

PMID:36585488

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9803880/

Abstract

PURPOSE

Information is limited about adherence to practice guidelines in patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or HIV infection receiving anticancer treatment.

METHODS

Newly diagnosed adult cancer patients were enrolled in a multicenter, prospective cohort study (SWOG S1204) during 2013-2017 to evaluate the prevalence of HBV, HCV, or HIV in patients initiating anticancer treatment. At 6 months, records of virus-positive patients were reviewed for antiviral therapy use; anticancer treatment dose reduction; and HBV reactivation (elevated viral load). Categorical variables were compared using chi-square or Fisher's exact test.

RESULTS

Of 3055 enrolled patients with viral testing, 230 had chronic or past HBV, HCV, or HIV with 6-month follow-up data (chronic HBV, 15 patients; past HBV, 158; HCV, 49; HIV, 30). Twenty percent (3/15) of chronic HBV and 11% (17/158) of past HBV patients were co-infected with HCV and/or HIV. Rates of antiviral therapy use by 6 months were as follows: chronic HBV, 85% (11/13); past HBV receiving anti-B cell therapy, 60% (3/5); past HBV receiving systemic anticancer therapy without anti-B cell therapy, 8% (8/105); HCV, 6% (2/35); and HIV, 90% (19/21). Among patients with available data, anticancer treatment dose was reduced in 1 of 145 patients with past HBV and 1 of 42 with HCV. HBV reactivation occurred in 1 of 15 patients with chronic HBV; this patient was not receiving antiviral therapy.

CONCLUSION

Many patients with cancer and viral infections either do not receive guideline-recommended antiviral treatment or receive antiviral treatment that is not recommended in guidelines. Further education is needed to improve adherence to guidelines.

摘要

目的

在接受癌症治疗的乙型肝炎病毒 (HBV)、丙型肝炎病毒 (HCV) 或人类免疫缺陷病毒 (HIV) 感染者中，有关其对治疗实践指南的遵循情况的信息有限。

方法

在 2013 年至 2017 年期间，新诊断的成年癌症患者参加了一项多中心前瞻性队列研究（SWOG S1204），以评估开始接受癌症治疗的患者中 HBV、HCV 或 HIV 的流行情况。在 6 个月时，对病毒阳性患者的记录进行了审查，以评估抗病毒治疗的使用情况、癌症治疗剂量的减少情况以及乙型肝炎病毒的再激活（病毒载量升高）情况。使用卡方检验或 Fisher 确切概率法比较分类变量。

结果

在接受病毒检测的 3055 例入组患者中，有 230 例患有慢性或既往 HBV、HCV 或 HIV，并且有 6 个月的随访数据（慢性 HBV，15 例；既往 HBV，158 例；HCV，49 例；HIV，30 例）。20%（3/15）的慢性 HBV 患者和 11%（17/158）的既往 HBV 患者合并感染 HCV 和/或 HIV。6 个月时抗病毒治疗的使用率如下：慢性 HBV，85%（11/13）；接受抗 B 细胞治疗的既往 HBV，60%（3/5）；接受系统抗癌治疗而无抗 B 细胞治疗的既往 HBV，8%（8/105）；HCV，6%（2/35）；HIV，90%（19/21）。在有可用数据的患者中，有 1 例既往 HBV 患者和 1 例 HCV 患者减少了癌症治疗剂量。15 例慢性 HBV 患者中有 1 例发生了乙型肝炎病毒再激活；该患者未接受抗病毒治疗。