An Updated Follow-Up of Chronic Hepatitis C After Three Decades of Observation in Pediatric Patients Cured of Malignancy

作者：Cesaro Simone^*; Bortolotti Flavia; Petris Maria Grazia; Brugiolo Alessandra; Guido Maria; Carli Modesto

来源：Pediatric Blood and Cancer, 2010, 55(1): 108-112.

DOI：10.1002/pbc.22438

• chronic hepatitis C
• cirrhosis
• interferon
• pediatric malignancy
• ribavirin

Background. The aim of the study was to evaluate the clinical characteristics and the long-term outcome of chronic hepatitis C in a cohort of Caucasian children cured of pediatric malignancy. Procedure. The study population included 83 consecutive patients, referred to our Center with a diagnosis of leukemia/lymphoma (50) or solid tumors (33) between 1977 and 1989 and infected with hepatitis C virus (HCV) during chemotherapy. Results. At enrollment 77 subjects were HCV-RNA positive. After a median follow-up of 21 years (range 13-36), a sustained virological response (SVR) was obtained in 3 of 29 patients (10%) treated with interferon (IFN), in 1 of 3 patients (33%) treated with IFN and ribavirin, and in 5 of 11 patients (42%) treated with pegylated-IFN and ribavirin (P=0.03). Forty-two patients remained untreated and only one (2.5%) cleared viremia. Four of 77 patients (5%) developed cirrhosis while other 4 patients died of causes not related to liver. At last follow-up, 72% of HCV-RNA positive patients had abnormal ALT. Conclusions. In patients cured of pediatric malignancy chronic hepatitis C tends to run an indolent course during childhood and adolescence but more than 70% of treated and more than 80% of untreated cases children maintained HCV viremia. Moreover, after 2-3 decades of observation, 60% of HCV-RNA positive patients had abnormal ALT and 5% had developed cirrhosis. Among treated patients, IFN or pegylated-IFN and ribavirin obtained the higher rate of HCV-RNA clearance. Pediatr Blood Cancer 2010;55:108-112.

• 出版日期2010-7-15