The epidemiology of chronic hepatitis C infection in survivors of childhood cancer: An update of the St Jude Children's Research Hospital hepatitis C seropositive cohort

Sharon Castellino, Shelly Lensing, Caroline Riely, Shesh N. Rai, Rene Davila, Randall T. Hayden, Jackie Fleckenstein, Mark Levstik, Shari Taylor, Patrick J. Dean, Sarah Kippenbrock, Jennifer Pope, Jeanne Carr, Donald K. Strickland, Melissa M. Hudson

Research output: Contribution to journalArticlepeer-review

80 Scopus citations

Abstract

Childhood cancer survivors transfused before 1992 are at risk for chronic hepatitis C (HCV), infection. In 1995, St Jude Children's Research Hospital initiated an epidemiologic study of childhood cancer survivors with transfusion-acquired HCV. Of the 148 survivors with HCV confirmed by second-generation enzyme immunoassay, 122 consented to participate in the study. Their current median age is 29 years (range, 9 to 47 years). At enrollment, polymerase chain reaction (PCR) testing indicated chronic infection in 81:1%; genotype 1 was the most common viral genotype. Liver biopsy in 60 patients at a median of 12.4 years from the diagnosis of malignancy showed mild (28.8%) or moderate (35.6%) fibrosis; 13.6% had cirrhosis. Elevated body mass index was associated with histologic findings of increased steatosis (P = .008). Antimetabolite chemotherapy exposure was associated with early progression of fibrosis. Significant quality-of-life deficits were observed in noncirrhotic adult survivors. Antiviral therapy resulted in clearance of infection in 17 (44%) of 38 patients to date. Six patients have died; 1 patient with decompensated cirrhosis died of variceal bleeding. Despite a young age at HCV infection, the progression of liver disease in childhood cancer survivors is comparable to that seen in adults.

Original languageEnglish
Pages (from-to)2460-2466
Number of pages7
JournalBlood
Volume103
Issue number7
DOIs
StatePublished - Apr 1 2004

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