Abstract 230 - IMPIEGO DEI GLICOPEPTIDI NELLA ... - SIMIT

237
10° CONGRESSO NAZIONALE SIMIT
Abstract 156
- INCIDENCE OF HEPATITIS B AND C INFECTIONS IN EARLY BREAST CANCER
PATIENTS AND IMPACT ON SYSTEMIC TREATMENT -
De Maria A.* [1] , Levaggi A. [2] , Iacono G. [2] , Giraudi S. [2] , Bighin C. [2] , Lambertini M. [2] , Canavese G. [2] , Pronzato
P. [2] , Del Mastro L. [2]
- [1] MALATTIE INFETTIVE, IST-GE ~ GENOVA - [2] ISTITUTO NAZIONALE PER LA RICERCA SUL CANCRO ~
GENOVA
INFEZIONI DA VIRUS EPATITICI
Premessa: little information exists about the incidence of hepatitis B and C infections in
early breast cancer patients and the impact on systemic treatment
Obiettivo: we retrospectively reviewed hepatitis B or C serology of 746 consecutive
patients with early breast cancer treated at National Institute for Cancer Research between
January 2009 and March 2011 to assess the impact of HBV or HCV infection on systemic
cancer treatment. Patients with positive serology were elegible for this study.
Risultati: 170 patients were excluded because serology was not available. Among 576
evaluable patients we indentified 28 (4.8%) patients vaccinated against HBV and 69 (12%)
with positive serology: 17 patients (2.9%) with HCV infection, 7 (1.2%) with occult HBV
(HBsAg negative, HBsAg Ab negative, HBcAg Ab positive) , 40 (6.9%) with cleared HBV
(HBsAg negative, HBsAg Ab positive, HBcAg Ab positive) and 6 (1%) with chronic HBV
(HBsAg positive, HBsAg Ab negative, HBcAg Ab positive). Eleven patients (16%)
experienced a grade 1 or greater elevation in aminotransferases during systemic therapy
as follows: CTC grade 1 (five patients), grade 2 (eight) and grade 3 (one)(table 1). Among
the patients who developed an elevation in aminotransferases, 6 (54.5%) had HCV
infection, 2 (18%) had chronic HBV while no patients had occult HBV. Among patients with
transaminitis two patients HCV positive (18%) required discontinuation of systemic
therapy: one patient discontinued hormonetherapy and one trastuzumab.
Conclusione: about 12% of newly diagnosed breast cancer patients have positive
serology for viral hepatitis and within this group about 16% may develop transaminitis
during systemic treatment. Discontinuation of systemic treatment can occur in about 18%
of patients with elevation in transaminases. Pretreatment serum detection of viral hepatitis
B and C antigen and antibodies is useful for adeguate monitoring of liver function during
anti-neoplastic therapy
CT ± OT CT + T ± OT OT Total
HCV (17 pt) 1 (5.8%) 1 (5.8%) 4 (23.5%) 6 (35.1%)
Occult HBV (7 pt) 0 0 0 -
Cleared HBV (40 pt) 1 (2.5%) 2 (5%) 0 3 (7.5%)
Chronic HBV (6 pt) 2 (33.3%) 0 0 2 (33.3%)