Chronic hepatitis C virus infection after treatment for pediatric malignancy.
Sera of 658 patients who had completed treatment for pediatric malignancy were analyzed by a second-generation enzyme-linked immunosorbent assay and recombinant immunoblot assay test to assess the prevalence of hepatitis C virus (HCV)-seropositivity. All HCV-seropositive patients underwent detailed clinical, laboratory, virologic, and histologic study to analyze the course of HCV infection. One hundred seventeen of the 658 patients (17.8%) were positive for HCV infection markers. Among the 117 anti-HCV+ patients, 41 (35%) were also positive for markers of hepatitis B virus infection with or without delta virus infection markers, 91 (77.8%) had previously received blood product transfusions, and 25 (21.4%) showed a normal alanine aminotransferase (ALT) level during the last 5-year follow-up (11 of them never had abnormal ALT levels). The remaining 92 patients showed ALT levels higher than the upper limit of normal range. Eighty-one of 117 (70%) anti-HCV+ patients were HCV-RNA+, with genotype 1b being present in most patients (54%). In univariate analysis, no risk factor for chronic liver disease was statistically significant. In this study, the prevalence of HCV infection was high in patients who were treated for a childhood malignancy. In about 20% of anti-HCV+ patients, routes other than blood transfusions are to be considered in the epidemiology of HCV infection. After a 14-year median follow-up, chronic liver disease of anti-HCV+ positive patients did not show progression to liver failure.
Cesaro
S
S
Department of Pediatrics, Università di Padova, Italy.
Petris
M G
MG
Rossetti
F
F
Cusinato
R
R
Pipan
C
C
Guido
M
M
Masiero
L
L
Botta
G A
GA
Meloni
G A
GA
Zanesco
L
L
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers; D001706:Biopsy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000201:enzymology / Q000453:epidemiology / Q000635:transmission; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology* / Q000635:transmission; D003699:Hepatitis D / Q000201:enzymology / Q000453:epidemiology / Q000635:transmission; D003698:Hepatitis Delta Virus / Q000276:immunology; D006518:Hepatitis Viruses / Q000276:immunology / Q000302:isolation & purification; D006521:Hepatitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology*; D006801:Humans; D008099:Liver / Q000473:pathology; D017093:Liver Failure / Q000453:epidemiology / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D065227:Transfusion Reaction
D015415:Biomarkers; D006508:Hepatitis Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase