Abstract | BACKGROUND & AIMS: METHODS: The medical records of HCV-infected patients seen at our institution (2008-2009) were analyzed retrospectively. Acute exacerbation was defined as greater than 3-fold increase in serum level of alanine aminotransferase, and viral reactivation as ≥ 1 log(10) IU/ml increase of HCV viral load following chemotherapy. RESULTS: Acute exacerbation occurred in 33 (11%) of 308 patients with proven HCV infection. Patients with acute exacerbation more often had underlying hematological malignancies (73% vs. 29%; p<0.001) and lymphopenia (6% vs. 0%; p=0.01) than patients without it. In multivariate analysis, underlying hematological malignancies (p=0.02; odds ratio, 3.2; 95% confidence interval, 1.2-8.7) and use of rituximab (p=0.004; odds ratio, 4.2; 95% confidence interval, 1.6-10.9) were associated with acute exacerbation. Patients with acute exacerbation received higher median cumulative dose of rituximab than those without exacerbation. Discontinuation of chemotherapy due to liver dysfunction was more common in patients with acute exacerbation than in patients without it (45% vs. 11%; p<0.001). Eight (36%) of 22 patients with known pre- and post- chemotherapy viral load had viral reactivation. CONCLUSIONS:
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Authors | Parag Mahale, Dimitrios P Kontoyiannis, Roy F Chemaly, Ying Jiang, Jessica P Hwang, Marta Davila, Harrys A Torres |
Journal | Journal of hepatology
(J Hepatol)
Vol. 57
Issue 6
Pg. 1177-85
(Dec 2012)
ISSN: 1600-0641 [Electronic] Netherlands |
PMID | 22871500
(Publication Type: Journal Article)
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Copyright | Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. |
Chemical References |
- Antibodies, Monoclonal, Murine-Derived
- RNA, Viral
- Rituximab
- Alanine Transaminase
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Topics |
- Acute Disease
- Adult
- Aged
- Aged, 80 and over
- Alanine Transaminase
(blood)
- Antibodies, Monoclonal, Murine-Derived
(therapeutic use)
- Female
- Hepacivirus
(physiology)
- Hepatitis C, Chronic
(complications, drug therapy, physiopathology)
- Humans
- Male
- Middle Aged
- Neoplasms
(complications, virology)
- RNA, Viral
(analysis)
- Retrospective Studies
- Rituximab
- Virus Activation
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