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 hepatitits 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 immuno-suppression and liver toxicity).
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- anti-HCV:
-
antibody against-HCV
- CMV:
-
cytomegalovirus
- HCV:
-
hepatitis C virus
- NANB:
-
non-A-non-B
References
Chan SW, Simmonds P, McOmish F, Yap PL, Mitchell R, Dow B, Follet E (1991) Serological responses to infection with three different types of hepatitis C virus. Lancet 338:1391
Choo QL, Weiner AJ, Overby LR, Kuo G, Houghton M, Bradley DW (1990) Hepatitis C virus: The major causative agent of viral non-A, non-B hepatitis. Br Med Bull 46:423–441
Craxi A, Fiorentiona G, DiMarco V, Marino L, Magrin S, Fabriano C, Pagliaro L (1991) Second generation tests in diagnosis of chronic hepatitis C. Lancet 337:1354
DeBeenhouwer H, Volckaerts A, Claeys H, Vermylen C (1992) Confirmation of HCV positive blood donors by immunoblotting and PCR. Vox Sang (in press)
Entacher U, Jürgenssen O, Thun-Hohenstein L, Simbruner G, Khoss A, Wank H, Neuwirth G, Gadner H, Frisch-Niggemeyer W (1985) Hepatitis B vaccination in children with malignant diseases. Eur J Pediatr 144:160–163
Esteban JI, Gonzalez A, Hernandez JM, Viladomiu L, Sanchez C, Lopez-Talavera JC, Lucea D, Martin-Vega C, Vidal X, Esteban R, Guardia J (1990) Evaluation of antibodies to hepatitis C virus in a study of transfusion-associated hepatitis. N Engl J Med 323:1107–1012
Garson JA, Tedder RS, Briggs M, Tuke P, Glazebrook JA, Trute A, Parker D, Barbara JAJ, Contreras M, Aloysius (1990) Detection of hepatitis C viral sequences in blood donations by nested polymerase chain reaction and prediction of infectivity. Lancet I:1419–1422
Kamitsukasa H, Harada H, Jakura M, et al (1989) Intrafamilial transmission of hepatitis C virus. Lancet II:987
Kühnl P, Seidl S, Stangel W, Beyer J, Sibrowsky W, Flik J (1989) Antibody to hepatitis C virus in German blood donors. Lancet II:324
Kuo G, Choo QL, Alter HJ, Gitnick GL, Redeker AG, et al (1989) An assay for circulating antibodies to a major etiologic virus of human Non-A, Non-B hepatitis. Science 244:362–364
Locasciulli A, Vergani G, Uderzo C (1983) Chronic liver disease in children with leukemia in long-term remission. Cancer 52:1080–1087
Locasciulli A, Alberti A, Barbieri R (1983) Evidence of non-A-non-B hepatitis in children with acute leukemia and chronic liver disease. Am J Dis Child 137:354–356
Locasciulli A, Alberti A, Rossetti F (1986) Acute an chronic hepatitis in childhood leukemia: a multicentric study from the Italian Pediatric Cooperative Group for Therapy of Acute Leukemia (AIL-AEIOP). Med Pediatr Oncol 13:203–206
Locasciulli A, et al (1990) Hepatitis C virus infection and chronic liver disease in children with leukemia in longterm remission (abstract) 2nd International Symposion on HCV, Los Angeles, p 75
Malone W, Novak R (1980) Outcome of hepatitis in children with acute leukemia. Am J Dis Child 134:584–587
Ratner L, Peylan-Ramu N, Wesley R (1986) Adverse prognostic influence of hepatitis B virus infection in acute lmyphoblastic leukemia. Cancer 58:1096–1100
Sirchia G, Bellobuono A, Giovanetti A, Marconi M (1989) Antibodies to hepatitis C virus in Italian blood donors. Lancet II:797
Tabor E, Gerety RJ, Mott M, Wilbur J (1978) Prevalence of hepatitis B in a high-risk setting: a serologic study of patients and staff in a pediatric oncology unit. Pediatrics 61:711–715
Tamura I, Kobayashi Y, Koda T, Ichimura H, Kurimura O, Takasugi T, Kurimura T (1990) Hepatitis C virus antibodies in haemodialysis patients. Lancet I:1409
Van der Poel CL, Reesink HW, Schaasberg W, Leentvaar-Kuypers A, Bakker E, Exel-Oehlers PJ, Lelie PN (1990) Infectivity of blood seropositive for hepatitis C virus antibodies. Lancet I:558–560
Vranckx R, Van Damme P (1990) Hepatitis C in institutionalized children. N Engl J Med 323:64
Yamaguchi Y, Nishimura Y, Fukuoka N, Machida J, Ueda S, Kusumoto Y, Futami T, Ishii T, Takatsuki K (1990) Hepatitis C virus antibodies in haemodialysis patients. Lancet I:409–1410
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Fink, F.M., Höcker-Schulz, S., Mor, W. et al. Association of hepatitis C virus infection with chronic liver disease in paediatric cancer patients. Eur J Pediatr 152, 490–492 (1993). https://doi.org/10.1007/BF01955056
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01955056