Solid Tumor Clinical Trial
Official title:
Interest of Routine Screening for Hepatitis B and C in Patients Receiving Chemotherapy for Solid Tumors
Immunosuppression induced by cancer treatment increases the risk of hepatitis B virus (HBV)
and hepatitis C virus (HCV) reactivations. These viral reactivations may be asymptomatic but
can cause fulminant hepatitis and death. More, they impact the treatment of cancer by
chemotherapy delays or stops. They can occur during cancer treatment but also after
stopping, at the immunological rebound. This risk persists for at least 6 months after
cessation.
The key to the prevention, and the first step, is serological testing. It is also the main
problem because international recommendations diverge. Hepatologists and infectious disease
specialists recommend routine screening HBV of all candidates for immunosuppressive therapy.
These recommendations are more implemented by hematologists, given the frequency of HBV
reactivation associated to haematological malignancies. Clinical oncology societies
guidelines suggest a selective screening in case of risk factors of hepatitis B or in
patients with a strong immunosuppression (such as anti-CD20 based treatment, stem cell
transplantation or lymphoma treatment).
The consequence of these differences is a sub-screening by oncologists and the persistence
of fatal cases. Screening before cytotoxic chemotherapy for solid tumors in countries with
low prevalence of HBV and HCV virus is questionable. Selective screening of patients at risk
HBV and HCV can be assessed.
The aims of the study were :
evaluate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in
patients receiving cytotoxic chemotherapy for solid tumors.
assess the relevance of screening questions to detect risk factors of hepatitis B virus
(HBV) and hepatitis C virus (HCV) and to analyze the patients with superior risk of viral
reactivation
;
Observational Model: Case-Only, Time Perspective: Prospective
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