Hepatitis Cvirus infection in non hodgkin's lymphoma patients: virological evaluation

Viral hepatitis is a common and important problem in immunocompromised cancer patients. The present study was conducted to investigate changes in some virological parameters as a consequence of Hepatitis C Virus [HCV] infection in non Hodgkin's lymphoma patients [NHL]. The Pediatric Service of the National Cancer Institute, Cairo University, Egypt. The study included 40 NHL patients: 20 anti-HCV antibody positive [Gr. I] and 20 anti-HCV antibody negative [Gr. II]. In addition, forty non-cancer controls [NCCs] were included: 20 of them were anti-HCV antibody positive [Gr. Ill] and 20 anti-HCV antibody negative [Gr. IV]. Virological studies included detection of HCV antibody [Ab] of both types [IgG and IgM] by ELISA. In addition. Line Immunoassay for HCV by LIA test as well as RT-PCR to detect HCV viremia were done. Eleven out of the twenty [55%] NHL patients from Gr. I had HCV antibody index value of > 6 in comparison to 8/20 [40%] only in their non-cancer controls. No difference was observed between the positivity of anti-HCV IgM Ab in NHL patients from Gr. I and their non-cancer controls in Gr. Ill; eleven out of 20 [55%] were positive for anti-HCV IgM Ab in both Gr. I and Gr. III. As regards confirmatory HCV-Ab patterns [LIA], nineteen out of 20 [95%] NHL patients of Gr I were LIA positive in comparison to 18 out of 20 [90%] NCCs of Gr. III. Further analysis showed that reactivity to both core and nonstructural regions combined was more frequent in NHL patients [18/19, 95%] than in their non-cancer controls [12/18, 67%]. HCV viremia was displayed by RT-PCR in 18 out of 20 [90%] NHL patients of Gr. I in comparison to 12 out of the 20 [60%] NCCs of Gr. III. From all the above virological findings two main inferences could be drawn: [1] HCV leads a mild course of infection in NCCs as evidenced by normal ALT level in all but 20% [4/20] of subjects, and hence a mild hepatocellular injury, and [2] In the immunocompromised NHL patients the virus leads a potentially more aggressive course as evidenced by higher percentage of positive HCV RNA in blood, higher .HCV-Ab titer and higher incidence of reactivity to both core and NS regions[s]

Seroprevalence of herpes simplex virus types 1 and 2, Epstein-Barr virus, and cytomegalovirus in children with acute lymphoblastic leukemia in Egypt

Viral infection, especially caused by herpes viruses, is now recognized as an important cause of morbidity and mortality in immunocompromised cancer patients. This study aimed at studying seroprevalence of 3 herpes viruses Herpes simplex virus types 1 and 2 [HSV 1 and 2], Epstein-Barr virus [EBV], and cytomegalovirus [CMV] in children with acute lymphoblastic leukemia [ALL]. We conducted this study on 68 newly diagnosed pediatric patients with ALL presented to the Pediatric Oncology Service of National Cancer Institute, Cairo University, Egypt from November 2001 to June 2003. We used enzyme-linked immunosorbent assay in detecting HSV 1 and 2, CMV, EBV antibodies of both types immunoglobulin [Ig] M and IgG detection of DNA for both CMV and EBV by polymerase chain reaction was carried out. High seroprevalence of HSV-1 and 2, CMV and EBV IgG antibodies in both leukemic children and their control was observed [69%, 100%, 83%] and [80%, 100%, 95%]. Significantly higher percentage of HSV-1 and 2 IgM or reactivated infection was found among leukemic children 17/68 [25%] compared with normal control 0%. Analysis showed that prevalence of HSV 1 and 2 IgG increased from 18/33 [54%] in children <5 years to 11/13 [77%] in children >10 years, and reactivation of HSV-1 and 2 increased with increasing age from 1/33 [3%] in children <5 years to 4/13 [30%] in children >10 year. This was in contrast to seroprevalence of CMV and EBV IgG which were 100% and 83% in children <5 years. No difference in seroprevalence was found among both gender, and no difference was found in leukemic patients with granulocytopenia. The data show a higher exposure to HSV-1 and 2 both primary infections and reactivation among ALL children. Therefore, acyclovir prophylaxis could be highly effective for seropositive leukemic patients who are undergoing induction chemotherapy