Association of hepatitis C virus infection with chronic liver disease in paediatric cancer patients

Abstract

A total of 203 paediatric cancer treatment survivors were tested for serum antibodies against hepatitis-C virus (anti-HCV). Anti-HCV was detected in 41 patients (20.2%) with first generation anti-HCV ELISA. Positive results were confirmed in all samples retested with a second generation ELISA (n = 35) and in all but two cases re-analysed by immunoblotting (n = 23). Anti-HCV positive children had received significantly more blood product transfusions compared to seronegative patients. In 75 children (32%) chronic liver disease was found. It was defined as an elevation of serum alanine aminotransferase values to a least 2.5 times the upper limit of normal persisting for 6 months or longer. Hepatitis A was never detected, and in 58 children the chronic hepatopathy was unexplained by hepatitis B (non-A non-B chronic liver disease). Of these patients 29 (50%) were seropositive for anti-HCV. Surprisingly, non-A/non-B chronic liver disease was associated with anti-HCV in 14 of 19 solid tumour patients (78.9%), but in no more than 14 of 39 leukaemia and lymphoma patients (35.9%). This phenomenon was not explained by different rates of cytomegalovirus disease and drug toxicity related hepatopathies between the two groups. It may be related to differences of leukaemia/lymphoma compared to solid tumour therapy schedules (differential immunosuppression and liver toxicity).

Prospective evaluation of late effects after childhood cancer therapy with a follow-up over 9 years

“…Hepatic late eects are mainly caused by chronic HBV and/or HCV infections [16,25,26,35,37]. In the present study, 26 patients (12%) had chronic liver disease.…”

Hepato‐biliary late effects in survivors of childhood and adolescent cancer: A report from the Children's Oncology Group

“…[13,42,43,45–47] Chronic infection is common, evidenced by PCR detection of viral RNA ranging from 70% to 100%. [13,45–47] Most patients are asymptomatic, with elevated ALT values in 29% to 79%.…”

“…[13,42,43,45–47] Chronic infection is common, evidenced by PCR detection of viral RNA ranging from 70% to 100%. [13,45–47] Most patients are asymptomatic, with elevated ALT values in 29% to 79%. Chronically infected survivors develop progressive fibrosis and cirrhosis at rates similar to adult HCV cohorts, or hemophiliacs co-infected with human immunodeficiency virus (HIV) and HBV.…”

Stabilization of Proteins and Peptides in Diagnostic Immunological Assays by the Molecular Chaperone Hsp25

“…Clinical studies indicate that the majority of patients who acquire HCV develop chronic hepatic diseases. Currently, there is no effective anti-HCV therapy and no passive or active immunization protocol for HCV (31,32).…”