新規診断びまん性大細胞型B細胞リンパ腫におけるHIV、HBV、およびHCV検査：包括的がんセンターでの経験

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype non-Hodgkin lymphoma. HIV, hepatitis B (HBV), and hepatitis C (HCV) infections are DLBCL risk factors. DLBCL remains a leading cause of cancer-related morbidity and mortality in those with HIV. DLBCL treatments can also increase the HBV reactivation risk and acute liver injury in HCV. We assessed HBV, HCV, and HIV screening rates in DLBCL patients receiving systemic therapy in a comprehensive cancer system.

We analyzed newly diagnosed DLBCL patients receiving anti-CD20 therapies between January 2018 and December 2023. Patients were considered screened if they had viral testing or a prior diagnosis within 12 months before to 3 months after starting treatment. We used chi-squared and Fisher's exact tests to examine associations between patients who were and were not screened HBV, HCV, and HIV. We used univariate and multivariate logistic regression to identify the factors associated with screening.

A total of 535 patients with DLBCL were treated (median age 64, 42% female, 82% white). Among these patients, 410 (77%) had HBV testing or a known infection, 275 (51.4%) had HIV testing or a known infection, and 307 (53%) had HCV testing or a known infection. Younger people were more likely to be tested for HIV and HCV. There was no association between age and HBV testing.

Pre-treatment HIV, HBV, and HCV screening rates in newly diagnosed DLBCL patients remains suboptimal. Interventions to increase viral testing in this population could help reduce treatment-related morbidity and mortality.