EVIDENCE AGAINST THE ROLE OF HEPATITIS-C VIRUS IN SEVERE LIVER-DAMAGEOCCURRING EARLY IN THE COURSE OF ACUTE-LEUKEMIA IN CHILDREN

Severe liver damage revealed by a sharp transaminase elevation may be seen in patients with leukemia. This may be due to several possible ca uses, including viral hepatitis, chemotherapy-induced hepatotoxicity a nd leukemic infiltration. HCV infection may be suspected to play a rel evant role as these patients are often heavily transfused after the on set of their hematologic disorder. We have therefore examined the role of HCV in 15 children with leukemia who developed severe liver damage shortly after the diagnosis of leukemia. All patients were tested for HCV-RNA by the polymerase chain reaction at the time of peak SGPT ele vation and for anti-HCV on serial serum samples taken thereafter. Only one patient (6.6%) showed hepatitis C viremia and none developed conf irmed anti-HCV positivity during follow-up, suggesting that HCV had no t played a major role in causing these severe episodes of liver necros is. This is in agreement with observations made in non-immunocompromis ed patients in whom fulminant hepatitis is only exceptionally due to H CV.