Lipid profile and hepatic steatosis in hepatitis C infected egyptian survivors of childhood cancer.
OBJECTIVE
Studies associating chronic hepatitis C virus (HCV) infection with lipid profile and hepatic steatosis in children and adolescents are scarce. This study investigated lipid profile abnormalities and hepatic steatosis among HCV-infected Egyptian children and adolescents who survived leukemia and lymphoma and evaluated impact on response to antiviral therapy.


METHODS
Thirty-six leukemia/lymphoma cured children and adolescents (mean age: 12.47 ± 3.56 years) with chronic HCV infection and 30 healthy controls (mean age: 11.64 ± 3.96 years) were enrolled in this prospective study. Serum lipid profile and abdominal ultrasonography were done for all patients and controls. Guided liver biopsy with histopathological examination was done for 32 (88.9%) patients eligible for antiviral therapy.


RESULTS
Total cholesterol, LDL-cholesterol, and apolipoprotein B (apo-B) in patients were significantly lower than in the control group (P ≤ .01, ≤ .01, and ≤ .05, respectively). Among those who underwent liver biopsy (n = 32), macrovesicular hepatic steatosis associated with chronic hepatitis C was documented in 10 children (31.3%). Body mass index was significantly higher (P ≤ .05) and apo-B was significantly lower in steatotic (P ≤ .05) than non-steatotic HCV-infected children. Liver span by ultrasound, alanine aminotransferase (ALT), and apo-B were independent predictors for hepatic steatosis (P < .001, <.001, and <.05, respectively). A significantly worse response to interferon alpha 2-b plus ribavrin treatment for HCV was reported among children with steatosis (P < .001).


CONCLUSIONS
The study showed low serum lipids in HCV-infected children with cured leukemia/lymphoma. Hepatic steatosis was found in a significant proportion of patients and was associated with a poor response to antiviral treatment.
Department of Pediatrics, Children's Hospital, Ain Shams University , Cairo , Egypt.
Mohammed Mostafa
MM
Al-Tawil
Ahmed Saeed
AS
Shoeeb
Amal
A
Abbas
Ahmed
A
El-Tawil
Manal Hamdy
MH
El-Sayed
D000293:Adolescent; D002648:Child; D004534:Egypt; D005234:Fatty Liver / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D007938:Leukemia; D008055:Lipids / Q000097:blood*; D008223:Lymphoma; D008297:Male; D011446:Prospective Studies; D017741:Survivors; D014463:Ultrasonography
D008055:Lipids
hepatic steatosis; hepatitis C virus infection; lipid profile; survivors of childhood cancer