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Prevalence and Natural History of Hepatitis C Infection in Patients Cured of Childhood Leukemia
Anna Locasciulli,
Marina Testa,
Patrizia Pontisso,
Luisa Benvegnù,
Donatella Fraschini,
Adele Corbetta,
Franco Noventa,
Giuseppe Masera, and
Alfredo Alberti
From the Clinica Pediatrica Università di Milano, Department of Pediatric Hematology, S. Gerardo Hospital, Monza; and Clinica Medica II, Università di Padova, Padova, Italy.
The aim of this study was to ascertain prevalence and natural history of hepatitis C virus (HCV) infection in a large cohort of patients cured of childhood leukemia who had been followed prospectively for liver disease for at least 10 years since chemotherapy withdrawal: 114 consecutive patients entered the study. Liver function tests and ultrasonography were used to assess presence of liver disease. Patients were tested for antibody to HCV and for serum HCV-RNA at the end of chemotherapy and at the end of follow-up. At chemotherapy withdrawal, 56 patients (49%) were HCV-RNA positive, often without detectable anti-HCV, and in these cases, transaminase levels were more elevated during (P = .08) and after (P = .04) chemotherapy compared with HCV-RNA negative cases. Patients were then followed-up 13 to 27 years (mean, 17) after chemotherapy withdrawal. During this period, 38 initially anti-HCV negative patients seroconverted to anti-HCV and 17 initially anti-HCV positive cases lost reactivity. Forty patients were persistently HCV-RNA positive in serum, while 16 initially viremic patients became HCV-RNA negative during follow-up. At the end of the observation period, a persistent transaminase elevation was detected only in four HCV-RNA positive and anti-HCV positive cases, while no patient developed signs or symptoms of decompensated liver disease. Thus, hepatitis C was a frequent finding in long-term survivors after chemotherapy. It was associated with an atypical serologic profile and did not cause severe liver impairment over a period of 13 to 27 years.
Blood, Vol. 90 No. 11 (December 1), 1997:
pp. 4628-4633
© 1997 by The American Society of Hematology.
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