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
| Autor: | Jackie Fleckenstein, Shelly Lensing, Mark Levstik, Donald K. Strickland, Jennifer Pope, Patrick J. Dean, Melissa M. Hudson, Caroline A. Riely, Jeanne Carr, Rene Davila, Sharon. M. Castellino, Sarah Kippenbrock, Shesh N. Rai, Shari Taylor, Randall T. Hayden |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Cirrhosis Alcohol Drinking Hepatitis C virus Immunology medicine.disease_cause Biochemistry Cohort Studies Liver disease Risk Factors Neoplasms Internal medicine Epidemiology Ethnicity medicine Humans Survivors Age of Onset Child Retrospective Studies medicine.diagnostic_test business.industry Cell Biology Hematology Hepatitis C medicine.disease Surgery Chronic infection Liver biopsy Female business Follow-Up Studies Cohort study |
| Zdroj: | Blood. 103:2460-2466 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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