Risk Prediction of Hepatitis B or C or HIV Among Newly Diagnosed Cancer Patients
Menée à partir de questionnaires auprès de 3 051 patients atteints d'un cancer récemment diagnostiqué, cette étude identifie sept facteurs associés au risque d'infection passée ou chronique au virus VHB, VHC ou VIH et évalue la performance d'un système de score intégrant ces facteurs de risque pour prédire la présence d'une infection virale
Background : Screening for viral infection in cancer patients is inconsistent. A mechanism to readily identify cancer patients at increased risk of existing or prior viral infection could enhance screening efforts while reducing costs.
Methods : We identified factors associated with increased risk of past or chronic HBV, HCV, or HIV infection prior to initiation of systemic cancer therapy. Data were from a multicenter prospective cohort study of 3,051 patients with newly diagnosed cancer (SWOG-S1204) enrolled between 2013-2017. Patients completed a survey with questions pertaining to personal history, behavioral, socioeconomic, and demographic risk factors for viral hepatitis or HIV. We derived a risk model to predict the presence of viral infection in a random set of 60% of participants using best subset selection. The derived model was validated in the remaining 40% of participants. Logistic regression was used.
Results : A model with 7 risk factors was identified, and a risk score with 4 levels was constructed. In the validation cohort, each increase in risk level was associated with nearly a threefold increased risk of viral positivity (OR = 2.85, 95%-CI, 2.26-3.60, p<0.001). Consistent findings were observed for individual viruses. Participants in the highest risk group (with
≥
3 risk factors), comprised of 13.4% of participants, were 18 times more likely to be viral positive compared to participants with no risk factors (OR = 18.18, 95%-CI, 8.00-41.3, p<0.001).
Conclusions and Relevance : A risk-stratified screening approach using a limited set of questions could serve as an effective strategy to streamline screening for individuals at increased risk of viral infection.
Journal of the National Cancer Institute , résumé, 2022