Chronic hepatitis B surface antigen-negative hepatitis after treatment of malignancy.
We reviewed the records of all patients with a diagnosis of malignancy who were treated at our center and who had not had chemotherapy for at least 18 months, to assess the prevalence of chronic hepatitis B surface antigen (HBsAg)-negative hepatitis, to assess the prevalence of a marker of hepatitis C virus infection, and to determine the severity of chronic liver disease. Of 557 eligible patients, 38 (6.8%) had chronic HBsAg-negative hepatitis. Of these 38 patients, 20 (52.6%) had a marker of hepatitis C virus infection. The prevalence of chronic HBsAg-negative hepatitis was higher in patients previously treated for leukemia than in patients treated for another malignancy (11.8% vs 4.6%; p = 0.004). The liver biopsy revealed chronic active hepatitis or cirrhosis or both in 8 (28%) of 28 patients with clinical chronic HBsAg-negative hepatitis. Four patients without hepatitis C virus infection who underwent liver biopsy had hepatitis B virus antigen in the liver, confirmed by immunohistochemistry studies. One patient uninfected with hepatitis C virus had hemochromatosis. We conclude that infection with hepatitis C virus was the major cause of chronic HBsAg-negative hepatitis in pediatric patients previously treated for malignancy; the cause remained unidentified in 30% of the patients.
Rossetti
F
F
Department of Pediatrics, University of Padova, Italy.
Cesaro
S
S
Pizzocchero
P
P
Cadrobbi
P
P
Guido
M
M
Zanesco
L
L
D000410:Alanine Transaminase / Q000097:blood; D000914:Antibodies, Viral / Q000032:analysis; D001323:Autoantibodies / Q000032:analysis; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006505:Hepatitis / Q000201:enzymology / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006526:Hepatitis C / Q000201:enzymology / Q000453:epidemiology*; D006521:Hepatitis, Chronic / Q000201:enzymology / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D007938:Leukemia / Q000188:drug therapy; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D015995:Prevalence
D000914:Antibodies, Viral; D001323:Autoantibodies; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D000410:Alanine Transaminase