HCV Infection May Cause Cancers Outside the Liver

In a study published in the journal Cancer, researchers conducted a registry-based controlled study to analyze the prevalence of cancer in patients with hepatitis C virus (HCV), to establish a link between HCV and other cancers.

The researchers found that HCV infection may be linked to more cancers besides hepatocellular carcinoma, as well as certain types of non-Hodgkin lymphoma.

It is well known that patients with HCV can develop cirrhosis, which can lead to hepatocellular carcinoma if treatment is not initiated. These patients may require costly transplants if their condition remains undiagnosed, or is not properly treated before significant damage occurs. In another article, which was a population-based cohort study, researchers from the United Kingdom analyzed the risk of developing hepatocellular carcinoma based on cirrhosis etiology. The researchers found that adjusted relative risk of hepatocellular carcinoma is augmented in patients who developed cirrhosis as a result of a viral infection, or an autoimmune or metabolic complication.

Although treatment with newer HCV drugs can be quite costly, it may be offset by avoiding hospitalizations, transplants, and new cases of cancer.

In the study, the authors explored the link between HCV and other cancers in adults 66 years and older who are insured through Medicare. The investigators used data from 1,623,538 patients with cancer and 200,000 control patients included in the Surveillance, Epidemiology, and End Results-Medicare database.

“We found that HCV was more prevalent in the cases than in the controls, and that it was positively associated with multiple cancer types,” said researcher Jennifer Kramer, PhD. “This shows us that HCV is associated with an increased risk of cancers outside of hepatocellular carcinoma and supports a potential causative role of HCV in an expanded group of cancers.”

Besides liver cancer, the authors found that HCV can potentially be linked to cancers of the bile ducts, pancreas, anus, non-melanoma non-epithelial skin cancers, diffuse B-cell lymphoma, and myelodysplastic syndrome, according to the study.

“Some of the associations with HCV that we observed may not reflect a causal relationship, but HCV is known to be an important cause of liver cancer,” said researcher Parag Mahale, MBBS, PhD, MPH. “It is also plausible that the virus contributes to other cancers, such as bile duct cancer, lymphoma and perhaps myelodysplastic syndrome.”

While many older adults from the Baby Boomer generation are infected with HCV, few of them have been diagnosed. This can increase the prevalence of cancers associated with HCV due to long-term damage resulting from a lack of treatment with direct-acting antiviral drugs.

These findings could lead to new outreach initiatives to ensure that older adults are aware of the possibility of an HCV infection, and seek treatment before further damage is experienced. This could prevent numerous cases of cancer, and even reduce health care costs in the long run.

“As this population ages, it is important that elderly individuals previously infected with HCV understand their risk for liver disease and cancer down the road,” Dr. Kramer concluded. “When we know which patients are at a highest risk, we can better understand how to treat and manage these patients early on, through the use of direct-acting antivirals, for example.”