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Natural course of HCV infection in childhood cancer survivors
Supportive Care in Cancer, 10/30/09

Fioredda F et al. – The goal of this study was to describe the course of hepatitis C in a cohort of 105 survivors after childhood cancer. The outcome of hepatitis C in our patients is comparable to the one described in European cohorts of adult cancer survivors and perinatally infected subjects. Nevertheless, progression to high degrees of hepatic damage has to be monitored by a careful follow-up.

Methods

Data on chemo/radiotherapy, clinical status, serial alanine aminotransferase (ALT) evaluation, and virological parameters after end of treatment were collected for each patient
Liver biopsies, when performed, centrally evaluated by a pathologist

Results

All patients were alive at end of follow-up and did not show hepatic insufficiency
ALT evaluation along entire follow-up showed moderate (87%) or a remarkable (13%) cytolytic pattern
Young age at diagnosis, hematopoietic stem cell transplantation, and duration of infection significantly correlate with worse hepatic activity
Type of tumor and chemo and/or radiotherapy regimens did not influence pattern of hepatic cytolysis
Liver biopsy, centrally reviewed in 30% of cohort, showed 1 case of cirrhosis and mild fibrosis in 71% of group
Higher degrees of fibrosis did not seem to be related to any exposition to chemo/radiotherapy but correlated significantly with more remarkable cytolytic course

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