This cohort study describes prevalence rates of infection with hepatitis B virus,
hepatitis C virus, and HIV among patients with newly diagnosed cancer in academic
and
community oncology practices. What is the prevalence of hepatitis B virus, hepatitis
C virus, and HIV infection among
patients with newly diagnosed cancer? In this cohort study of 3051 patients with newly
diagnosed cancer, infection rates were
6.5% for previous hepatitis B virus, 0.6% for chronic hepatitis B virus, 2.4% for
hepatitis C virus, and 1.1% for HIV. Among patients with viral infections, 42.1% of
patients with chronic hepatitis B virus, 31.0% of patients with hepatitis C virus,
and
5.9% of patients with HIV were newly diagnosed through the study. Screening patients
with newly diagnosed cancer to identify hepatitis B virus and
hepatitis C virus infection before starting treatment may be warranted to prevent
viral
reactivation and adverse clinical outcomes; universal screening for HIV infection
may
not be warranted. Universal screening of patients with newly diagnosed cancer for
hepatitis B virus
(HBV), hepatitis C virus (HCV), and HIV is not routine in oncology practice, and experts
disagree about whether universal screening should be performed. To estimate the prevalence
of HBV, HCV, and HIV infection among persons with newly
diagnosed cancer. Multicenter prospective cohort study of patients with newly diagnosed
cancer (ie,
identified within 120 days of cancer diagnosis) at 9 academic and 9 community oncology
institutions affiliated with SWOG (formerly the Southwest Oncology Group) Cancer
Research Network, a member of the National Clinical Trials Network, with enrollment
from
August 29, 2013, through February 15, 2017. The data analysis was conducted using
data
available through August 17, 2017. The accrual goal was 3000 patients and the primary
end point was the presence of HBV
infection (previous or chronic), HCV infection, or HIV infection at enrollment. Patients
with previous knowledge of infection as well as patients with unknown viral viral
status
were evaluated. Of 3092 registered patients, 3051 were eligible and evaluable. Median
(range) age was
60.6 (18.2-93.7) years, 1842 (60.4%) were female, 553 (18.1%) were black, and 558
(18.3%) were Hispanic ethnicity. Screened patients had similar clinical and demographic
characteristics compared with those registered. The observed infection rate for previous
HBV infection was 6.5% (95% CI, 5.6%-7.4%; n = 197 of 3050 patients);
chronic HBV, 0.6% (95% CI, 0.4%-1.0%; n = 19 of 3050 patients); HCV, 2.4%
(95% CI, 1.9%-3.0%; n = 71 of 2990 patients); and HIV, 1.1% (95% CI,
0.8%-1.6%; n = 34 of 3045). Among those with viral infections, 8 patients
with chronic HBV (42.1%; 95% CI, 20.3%-66.5%), 22 patients with HCV (31.0%; 95% CI,
20.5%-43.1%), and 2 patients with HIV (5.9%; 95% CI, 0.7%-19.7%) were newly diagnosed
through the study. Among patients with infections, 4 patients with chronic HBV (21.1%;
95% CI, 6.1%-45.6%), 23 patients with HCV (32.4%; 95% CI, 21.8%-44.5%), and 7 patients
with HIV (20.6%; 95% CI, 8.7%-37.9%) had no identifiable risk factors. Results of
this study found that a substantial proportion of patients with newly
diagnosed cancer and concurrent HBV or HCV are unaware of their viral infection at
the
time of cancer diagnosis, and many had no identifiable risk factors for infection.
Screening patients with cancer to identify HBV and HCV infection before starting
treatment may be warranted to prevent viral reactivation and adverse clinical outcomes.
The low rate of undiagnosed HIV infection may not support universal screening of newly
diagnosed cancer patients.