CHRONIC HEPATITIS-C VIRUS-INFECTION AFTER TREATMENT FOR PEDIATRIC MALIGNANCY

Sera of 658 patients who had completed treatment for pediatric maligna ncy were analyzed by a second-generation enzyme-linked immunosorbent a ssay and recombinant immunoblot assay test to assess the prevalence of hepatitis C virus (HCV)-seropositivity. All HCV-seropositive patients underwent detailed clinical, laboratory, virologic, and histologic st udy to analyze the course of HCV infection. One hundred seventeen of t he 658 patients (17.8%) were positive for HCV infection markers. Among the 117 anti-HCV+ patients, 41 (35%) were also positive for markers o f hepatitis B virus infection with or without delta virus infection ma rkers, 91 (77.8%) had previously received blood product transfusions, and 25 (21.4%) showed a normal alanine aminotransferase (ALT) level du ring the last 5-year follow-up (11 of them never had abnormal ALT leve ls). The remaining 92 patients showed ALT levels higher than the upper limit of normal range. Eighty-one of 117 (70%) anti-HCV+ patients wer e HCV-RNA(+), with genotype 1b being present in most patients (54%). I n univariate analysis, no risk factor for chronic liver disease was st atistically significant. In this study, the prevalence of HCV infectio n was high in patients who were treated for a childhood malignancy. In about 20% of anti-HCV+ patients, routes other than blood transfusions are to be considered in the epidemiology of HCV infection, After a 14 -year median follow-up, chronic liver disease of anti-HCV+ positive pa tients did not show progression to liver failure, (C) 1997 by The Amer ican Society of Hematology.