Prevalence of chronic hepatitis in children with leukemia, 1996-2001: a single center experience

Background: There is a risk of viral hepatitis for children with leukemia. Both hepatitis B and C virus infections cause major problems in the management of leukemic patients. In this study, we evaluated the prevalence of HBV and HCV infections in children with leukemia receiving chemotherapy and blood products. Methods: 408 patients with leukemia (mean age=5.1 years) were screened for HBV and HCV in Ali Asghar Children's Hospital. Liver function tests, the number of transfusions, HBV and HCV serology were regularly monitored. In seropositive children, HBV-DNA and HCV-RNA were measured. Liver biopsies were performed in all patients with chronic hepatitis and the data of the study were analyzed using SPSS software. Results: HBsAg positivity, anti-HCV, and mixed HBV and HCV infections were found in 10 cases (2.5%), 8 cases (2%), and 1 case (0.2%) of children, respectively. Of HCV infected children, 8 had positive HCV-RNA. Mixed infection developed to chronic hepatitis in one case. Conclusion: Children with cancer are at a high risk for hepatitis B and C infections due to immunosuppression secondry to chemotherapy and multiple transfusions of blood products during the course of their disease. We observed an increasing incidence of chronic hepatitis B and C infections. Thus no patient developed any signs or symptoms of decompensated liver disease and did not suffer from any severe liver impairment over 8 to 20 years.