Reactivation of Hepatitis C Virus and Its Clinical Outcomes in Patients Treated with Systemic Chemotherapy or Immunosuppressive Therapy

• Published in: Gut and liver Vol. 11; no. 6; pp. 870 - 877
• Main Authors: Lee, Hae Lim, Bae, Si Hyun, Jang, Bohyun, Hwang, Seawon, Yang, Hyun, Nam, Hee Chul, Sung, Pil Soo, Lee, Sung Won, Jang, Jeong Won, Choi, Jong Young, Han, Nam Ik, Song, Byung Joo, Lee, Jong Wook, Yoon, Seung Kew
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 01.11.2017; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Adult; Aged; Female; hepacivirus; Hepacivirus - drug effects; Hepacivirus - physiology; hepatitis; Hepatitis C Antibodies - blood; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - virology; Humans; immunosuppression; Immunosuppression Therapy - adverse effects; Immunosuppressive Agents - adverse effects; Male; Middle Aged; Original; Retrospective Studies; RNA, Viral - blood; viral replication; Virus Activation - drug effects; 내과학; Hepatitis; Immunosuppression; Viral replication; Hepacivirus
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl16434

According to the results of several studies, the outcome of hepatitis C virus (HCV) reactivation is not as severe as the outcome of hepatitis B virus reactivation. The aim of this study was to evaluate the effect of pharmacological immunosuppression on HCV reactivation. The medical records of patients who underwent systemic chemotherapy, corticosteroid therapy, or other immunosuppressive therapies between January 2008 and March 2015 were reviewed. Subsequently, 202 patients who were seropositive for the anti-HCV antibody were enrolled. Exclusion criteria were: unavailability of data on HCV RNA levels, a history of treatment for chronic hepatitis C, and the presence of liver diseases other than a chronic HCV infection. Among the 120 patients enrolled in this study, hepatitis was present in 46 patients (38%). None of the patients were diagnosed with severe hepatitis. Enhanced replication of HCV was noted in nine (27%) of the 33 patients who had data available on both basal and follow-up HCV RNA loads. Reappearance of the HCV RNA from an undetectable state did not occur after treatment. The cumulative rate of enhanced HCV replication was 23% at 1 year and 30% at 2 years. Although enhanced HCV replication is relatively common in HCV-infected patients treated with chemotherapy or immunosuppressive therapy, it does not lead to serious sequelae.