Abstract
There is no consensus guideline concerning the management of chronic hepatitis C patients during chemotherapy, and immunosuppression. However, there are some suggestions in literature that hepatitis C viral load increases during chemotherapy and there is a risk of rebound immunity against hepatitis C after discontinuation of immunosuppression with a consequent liver injury. A close monitoring of liver function of these patients is prudent during treatment of haematological malignancy. Antiviral treatment is deferred after the completion of chemotherapy and recovery of patients' immunity to minimize the toxicity of treatment. A combination of pegylated interferon and ribavirin is the standard therapy in hepatitis C infected haematological patients.
Highlights
It is well known that reactivation of hepatitis B is a potential lethal complication of chemotherapy and prophylactic antiviral drugs are prudent during treatment of haematological malignancies
Hepatitis C infection is associated with an increased risk of veno-occlusive disease (VOD) and graft-versus-host disease (GVHD) of liver
Chronic hepatitis C infection is associated with thrombocytopenia, and the cause is multifactorial in most patients
Summary
It is well known that reactivation of hepatitis B is a potential lethal complication of chemotherapy and prophylactic antiviral drugs are prudent during treatment of haematological malignancies. On the contrary, it is not certain how chronic hepatitis C infection would affect the outcome of haematological malignancies and bone marrow transplantation patients. There are case reports of severe flare up of chronic hepatitis C in patients undergoing chemotherapy [1, 2] but case series review found such complications uncommon [3]. Longterm survivors of bone marrow transplantation recipients are more prone to the complications of hepatitis C infection [4] and treatment in this group of patients seems warranted. There is scanty data on management of chronic hepatitis C in haematology patients. The underlying pathogenesis and its impact on treatment are discussed
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