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Hepatitis C virus serum markers and liver disease in children with leukemia
during and after chemotherapy
A Locasciulli, D Cavalletto, P Pontisso, L Cavalletto, E Scovena, C Uderzo, G Masera and A Alberti
Division of Pediatric Hematology, University of Milano, Monza, Italy.
The pattern of hepatitis C virus (HCV) serum markers and liver disease was
investigated in 11 leukemic children showing anti-HCV reactivity at least
once during long-term observation to define the role of HCV infection and
the behavior of HCV serologic markers in this patient cohort. Antibodies to
HCV by first- and second-generation enzyme-linked immunosorbent assay
(ELISA) and by second-generation (four antigens) recombinant immunoblotting
assay (RIBA) and HCV-RNA by nested polymerase chain reaction (PCR) were
serially examined in serum. Liver disease was defined according to
transaminase levels. Seven of 11 patients were found HCV-RNA positive
during chemotherapy and after blood transfusion, 3 of 11 became viremic
during follow-up, and 1 of 11 was always HCV-RNA negative. Seroconversion
to anti-HCV positivity by second-generation ELISA occurred in all the
HCV-RNA positive children either during or after chemotherapy. Alanine
aminotransferase (ALT) levels were elevated in all the HCV-RNA positive
patients during antileukemic treatment and normalized in seven of them
after therapy withdrawal, despite persisting viremia. These results
indicate that HCV- RNA testing by polymerase chain reaction is required to
correctly identify HCV infection in patients with leukemia while on
chemotherapy. Viremia did not correlate with ALT levels and anti-HCV
patterns.
Volume 82,
Issue 8,
pp. 2564-2567,
10/15/1993
Copyright © 1993 by The American Society of Hematology
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