title: High prevalence of occult hepatitis B in hepatitis C-infected Egyptian children with haematological disorders and malignancies.
abstract: OBJECTIVE
  This study investigates the prevalence of occult hepatitis B virus (HBV) in children and adolescents with haematological diseases with or without hepatitis C virus (HCV) infection.
  
  
  METHODS
  Forty-nine children with haematological disorders (median age 11.4 years) and 51 with haematological malignancies (median age 8 years) were enrolled. Sera were tested for HCV antibodies, HCV-RNA [nested reverse transcriptase polymerase chain reaction (PCR)], HBV markers (HBsAg, anti-HBcAb IgM and total, HBeAg) and HBV-DNA (nested PCR for s, c and x regions).
  
  
  RESULTS
  Anti-HCV was detected among 40/49 (81.6%) children with haematological disorders (24/49; 49% HCV-RNA positive) and 9/51 (17.6%) children with malignancies (12/51; 23.5% HCV-RNA positive). HBV-DNA was positive among 38%; positive c region in 33% (15/49 and 18/51 children with haematological disorders and malignancies respectively), s region in four leukaemics and x region in one leukaemic. Twenty-one patients had occult HBV infection; one (2.6%) was HBeAg positive, four (19%) total HBcAb positive, 20 (95.2%) c region HBV-DNA positive and one was s region positive (1/21; 4.8%). HCV-RNA was the significant predictor for occult HBV (P<0.05), with an increased frequency of HBV-DNA in the HBsAg negative (HCV-RNA positive) (63.2%) compared with patients negative for HCV-RNA (25%) (P=0.009).
  
  
  CONCLUSIONS
  Occult HBV infection is not uncommon in transfused immunocompromised children with chronic HCV infection. Nucleic acid amplification should be considered in screening donors as post-transfusion hepatitis B viraemia may be substantial.
authors.affiliation: Microbiology Department, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Egypt. znabil58@yahoo.com
authors.forename: Zeinab N A
authors.initials: ZN
authors.lastname: Said
authors.forename: Manal H
authors.initials: MH
authors.lastname: El-Sayed
authors.forename: Iman A
authors.initials: IA
authors.lastname: El-Bishbishi
authors.forename: Daad F
authors.initials: DF
authors.lastname: El-Fouhil
authors.forename: Soad E
authors.initials: SE
authors.lastname: Abdel-Rheem
authors.forename: Maha Z
authors.initials: MZ
authors.lastname: El-Abedin
authors.forename: Iman I
authors.initials: II
authors.lastname: Salama
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004279:DNA, Viral / Q000032:analysis; D004534:Egypt / Q000453:epidemiology; D005260:Female; D019337:Hematologic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology* / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis; D016036:Seroepidemiologic Studies; D065227:Transfusion Reaction
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral