Epidemiologic aspects and preventive strategy of hepatitis B and C viral infections in children with cancer

Aims. We present the efficacy of a strategy to control infections with hepa titis B (HBV) and C viruses (HCV) in children with cancer and assessment of risk for their relatives and health care personnel. A total of 1242 people entered the study, including 558 children with cancer, 193 relatives of in fected children, 302 health care workers and 189 controls. Methods. To stop dual HBV and HCV nosocomial infection in the oncology depa rtment, a preventive strategy was introduced. It involved immunoprophylaxis against HBV, screening blood donors for HCV infection, intensification of nonspecific prophylaxis, an educational program and estimation of risk for relatives of infected children and health care personnel. Results. Retrospective analysis showed that the prevalence of HBV and HCV i nfections in children with cancer was 74 of 119 (62.2%) and 50 of 92 (54.3% ), respectively, with the highest rate among patients with leukemia. Inferi or anticancer therapeutic response were obtained in infected children. Spec ific anti-HBV immunoprophylaxis introduced simultaneously with anticancer t herapy resulted in protection of 160 of 168 (95.2%) children in the first 4 years, when 62.9% of patients receiving therapy developed protective antib odies. Screening of blood donors and intensification of nonspecific prophyl axis reduced HCV prevalence to 2.8% during the most recent 1.5 years. Genot ype analysis showed that the risk of HCV infection was 0.5% for relatives o f infected children. The risk for health care personnel was 0 in the oncolo gy ward and 1.9% in the other departments, and it reached 0.53% in control group. Conclusions. The preventive strategy of viral hepatitis in children with ca ncer, including passive-active HBV immunoprophylaxis from the beginning of chemotherapy and intensive nonspecific prophylactic measures is effective. With this strategy the risk of intrafamily and occupational infection is lo w.