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Updated: Jul 26, 2025

An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
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Immune Checkpoint Inhibitors Suppress Hepatitis C Virus Replication in Infected Patients With Solid Tumors

Marcel Yibirin1, Khalis Mustafayev1, Jeff Hosry1

  • 1Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

The American Journal of Gastroenterology
|June 12, 2023
PubMed
Abstract

Insights

Immune checkpoint inhibitors (ICI) can inhibit hepatitis C virus (HCV) replication, potentially leading to virologic cure without direct-acting antivirals (DAA). HCV reactivation is rare and linked to immunosuppressants for ICI side effects, suggesting ICI are safe for HCV-infected patients.

Area of Science:

  • Oncology
  • Hepatology
  • Immunology

Background:

  • Limited data exist on immune checkpoint inhibitors (ICI) effects in patients with chronic hepatitis C virus (HCV) infection.
  • Assessing the virologic impact and safety of ICI in this population is crucial for treatment decisions.

Purpose of the Study:

  • To investigate the virologic impact of ICI on HCV viremia in patients with solid tumors.
  • To evaluate the safety profile of ICI in HCV-infected patients.

Main Methods:

  • A prospective observational study enrolled 52 patients with solid tumors treated with ICI.
  • Primary outcomes included ICI-induced changes in HCV viremia (inhibition and reactivation) and ICI safety.

Main Results:

  • Four patients (7.7%) experienced HCV inhibition, with one achieving undetectable viremia without DAA.
  • Two patients (4%) had HCV reactivation, primarily when on immunosuppressants for ICI-related toxic effects.
  • Adverse events were mostly low-grade (1-2); grade 3-4 events were ICI-related, not HCV-related. No HCV-associated liver failure or death occurred.

Conclusions:

  • ICI can lead to HCV inhibition and potential virologic cure in patients not receiving DAA.
  • HCV reactivation is uncommon and associated with immunosuppressive therapy for ICI toxicity.
  • ICI demonstrate a favorable safety profile in HCV-infected patients with solid tumors, supporting their use without contraindication.

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