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Hepatitis C Virus Infection and Chemotherapy in Breast Cancer: A Retrospective Chart Analysis
Ist Teil von
The oncologist (Dayton, Ohio), 2020-10, Vol.25 (10), p.845-852
Ort / Verlag
Hoboken, USA: John Wiley & Sons, Inc
Erscheinungsjahr
2020
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Background
Breast cancer and hepatitis C virus (HCV) infection are major health problems in the U.S. Despite these highly prevalent diseases, there is limited information on the effect of HCV infection among patients with breast cancer receiving chemotherapy and the potential challenges they face during treatment. Currently, there are no guidelines for chemotherapy administration in HCV‐positive patients with breast cancer.
Materials and Methods
We performed a retrospective case–control analysis on six patients with breast cancer with active HCV infection and 12 HCV‐negative matched controls who received chemotherapy between January 2000 and April 2015. We investigated dose delays, dose changes, hospitalization, hematologic reasons for dose delays, and variation in blood counts during chemotherapy from the patients’ medical records. Fisher's exact test was used for statistical comparison of the outcome variables between the two groups.
Results
When compared with the HCV‐negative patients, the HCV‐positive group was at a significantly higher risk of dose delays (100% vs. 33%, p value .013), dose changes (67% vs. 8%, p value .022), hospitalization during chemotherapy (83% vs. 25%, p value .043), and hematotoxicity related dose delays (83% vs. 8%, p value .003). HCV‐positive patients took a longer time to complete treatment than the HCV‐negative group.
Conclusion
Patients with HCV receiving chemotherapy for breast cancer are more likely to experience complications such as dose delays, dose modifications, and hospitalization. Future studies to confirm our findings and investigate on the effect of concurrent HCV and breast cancer treatment are warranted.
Implications for Practice
This study found that hepatitis C infection is associated with a greater risk of treatment delays and dose modifications in patients with breast cancer receiving cytotoxic chemotherapy. Hepatitis C–positive patients have a higher treatment burden with dose changes, hospitalizations, and longer treatment periods than noninfected patients. Further prospective investigations to confirm these findings are warranted in a larger patient population. Given that hepatitis C infection can be curable with direct‐acting antivirals, treatment of hepatitis C may alleviate treatment challenges during chemotherapy and improve survival for patients with breast cancer.
Currently, there are no guidelines for chemotherapy administration in hepatitis C virus‐positive patients with breast cancer. This article addresses the knowledge gap, comparing breast cancer patients with and without concurrent hepatitis C virus to determine level of tolerance to treatment.