Natural course of HCV infection in childhood cancer survivors.
OBJECTIVE
To describe the course of hepatitis C in a cohort of 105 survivors after childhood cancer.


METHODS
Data on chemo/radiotherapy, clinical status, serial alanine aminotransferase (ALT) evaluation, and virological parameters after the end of treatment were collected for each patient. Liver biopsies, when performed, were centrally evaluated by a pathologist.


RESULTS
All patients were alive at the end of follow-up and did not show hepatic insufficiency. ALT evaluation along the entire follow-up showed a moderate (87%) or a remarkable (13%) cytolytic pattern. Young age at diagnosis, hematopoietic stem cell transplantation, and duration of infection significantly correlate with a worse hepatic activity. Type of tumor and chemo and/or radiotherapy regimens did not influence the pattern of hepatic cytolysis. Liver biopsy, centrally reviewed in 30% of the cohort, showed one case of cirrhosis and mild fibrosis in 71% of the group. Higher degrees of fibrosis did not seem to be related to any exposition to chemo/radiotherapy but correlated significantly with the more remarkable cytolytic course.


CONCLUSIONS
The outcome of hepatitis C in our patients is comparable to the one described in European cohorts of adult cancer survivors and perinatally infected subjects. Nevertheless, progression to high degrees of hepatic damage has to be monitored by a careful follow-up.
Department of Pediatric Hematology, Oncology, and Bone Marrow Transplantation, Giannina Gaslini Children's Hospital, Largo Gerolamo Gaslini 5, 16147 Genoa, Italy. francescafioredda@ospedale-gaslini.ge.it
Francesca
F
Fioredda
Andrea
A
Moser
Luisella
L
Bertoluzzo
Herwig
H
Lackner
Raffaella
R
Giacchino
Milena
M
La Spina
Luisella
L
Lazier
Caterina
C
Riva
Mareva
M
Giacchino
Donatella
D
Fraschini
Eva
E
Frey
Angela
A
Sementa
Angela
A
Pistorio
Riccardo
R
Haupt
D000328:Adult; D017668:Age of Onset; D001706:Biopsy; D002648:Child; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D055815:Young Adult