High risk of occult HBV infection among children with hematological disorders and malignancies

ABSTRACT

Children receiving multiple transfusions or cancer chemotherapy are at an increased risk of acquiring and spreading hepatitis B [HBV] and/or hepatitis C [HCV] virus infections. Concurrent infections with both viruses are increasingly recognized and the reciprocal influence of dual infection remains controversial. Hepatitis B virus [HBV] infection in patients who lack detectable hepatitis B surface antigen [HB5Ag] is considered occult infection. To investigate the prevalence of occult HBV in children and adolescents with hematological disorders and malignancies with or without HCV infection. Cross-sectional retrospective study. Hematology/oncology clinic of Pediatric Department, Faculty of Medicine-Ain Shams University. 100 polytransfused children and adolescents. Forty nine children with hematological disorders [group 1; median age 11.4 yrs] and SI with hematological malignancies [group 2; median age 8 yrs] were enrolled in this study. Sera were tested for HCV antibodies. HCV-RNA [nested RT-PCR], HBV markers [HBsAg. Anti-HBcAb IgM and Total and UBeAg] and HBV-DNA [nested PCR for s, c and x regions] Anti-HCV was detected among 40/49 [81.6c/c] in group 1[24/49, 49<4 HCV-RNA+] and 9/51 [17 6%] in group 2 [12/51 23.5% HCV-RNA+]. Overall, HBV-DNA was positive among 38patients [21%] had occult HBV infection and twelve of them were HC V-RNA+ [8/49 in group I and 4/51 in group 2] whereas 8 patients [group 2] showed overt HBV-infection [HBSAg+/HBVDNA+/HCVRNA] Occult HBV infection is not uncommon in immunocompromised children with chronic HCV infection. The high prevalence of occult HBV-infection [particularly core DNA] may have clinical implications in the pathogenesis and therapy of HCV induced chronic liver disease