INCIDENCE AND MORBIDITY OF INFECTION BY HEPATITIS-C VIRUS IN CHILDRENWITH ACUTE LYMPHOBLASTIC-LEUKEMIA

A group of 90 patients with acute lymphoblastic leukaemia (ALL) in fir st continuous complete remission (CCR), admitted in our hospital betwe en January 1986 and September 1992, were tested for the presence of an tibodies against hepatitis C virus (HCV), antibodies against hepatitis B virus and antibodies against HIV-1 during maintenance therapy or th ereafter. They were compared with a group of 71 children with other ma lignancies in first CCR who had been diagnosed consecutively from Janu ary 1986 to September 1992. No patient with ALL or any other malignanc y was found to be positive for hepatitis B surface antigen or HIV-1. H CV-specific antibodies were detected in 28 out of 87 children (32. 1 % ) with ALL and in 4 out of 44 patients (9%) with malignancies other th an ALL who had received at least one transfusion of blood or platelets (P < 0.01). HCV-specific antibodies were also detected in one out of three untransfused children with ALL but in none of the untransfused c hildren with malignancies other than ALL. HCV-specific seropositivity influenced the management of children with ALL during maintenance ther apy. In fact, as a result of abnormal liver function tests, maintenanc e therapy had to be suspended significantly more often in the case of HCV- seropositive patients with ALL than in HCV-seronegative ones. Des pite the high morbidity during maintenance therapy, chronic liver dise ase (CLD) was uncommon in both groups: five children with ALL (17.2% o f HCV-seropositive children) and one child with a malignancy other tha n ALL (25%) had CLD. If a follow up for a longer period confirms these observations the impact of HCV-related CLD on the quality of life and survival of patients with ALL or other malignancies will probably be minimal.