High prevalence of occult hepatitis B in hepatitis C-infected Egyptian children with haematological disorders and malignancies

  1. Zeinab N.A. Said1,
  2. Manal H. El-Sayed2,
  3. Iman A. El-Bishbishi3,
  4. Daad F. El-Fouhil1,
  5. Soad E. Abdel-Rheem1,
  6. Maha Z. El-Abedin4,
  7. Iman I. Salama5

Article first published online: 28 JAN 2009

DOI: 10.1111/j.1478-3231.2009.01975.x

Issue

Liver International

Liver International

Volume 29, Issue 4, pages 518–524, April 2009

Additional Information

How to Cite

Said, Z. N.A., El-Sayed, M. H., El-Bishbishi, I. A., El-Fouhil, D. F., Abdel-Rheem, S. E., El-Abedin, M. Z. and Salama, I. I. (2009), High prevalence of occult hepatitis B in hepatitis C-infected Egyptian children with haematological disorders and malignancies. Liver International, 29: 518–524. doi: 10.1111/j.1478-3231.2009.01975.x

Author Information

  1. 1

    Microbiology Department, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Egypt

  2. 2

    Pediatric Hematology/Oncology Department, Ain Shams University, Cairo, Egypt

  3. 3

    The Biological Center for Diagnostic Products, Cairo, Egypt

  4. 4

    Pediatric Department, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Egypt

  5. 5

    Community Medicine Department, National Research Center, Cairo, Egypt

*Correspondence Prof. Dr Zeinab Nabil Ahmed Said, Microbiology Department, Faculty of Medicine (for girls), Al-Azhar University, Nasr City, 8, Ossama Ibn Monkez Street, Heliopolis, Cairo, Egypt Tel: +00 2 02 418 7236 Fax: +00 2 02 257 1305 e-mail: znabil58@yahoo.com

Publication History

  1. Issue published online: 10 MAR 2009
  2. Article first published online: 28 JAN 2009
  3. Received 2 August 2008Accepted 25 November 2008

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Keywords:

  • haematological diseases;
  • HBV/HCV co-infection;
  • occult hepatitis B;
  • transfusion

Abstract

Objective: This study investigates the prevalence of occult hepatitis B virus (HBV) in children and adolescents with haematological diseases with or without hepatitis C virus (HCV) infection.

Methods: Forty-nine children with haematological disorders (median age 11.4 years) and 51 with haematological malignancies (median age 8 years) were enrolled. Sera were tested for HCV antibodies, HCV-RNA [nested reverse transcriptase polymerase chain reaction (PCR)], HBV markers (HBsAg, anti-HBcAb IgM and total, HBeAg) and HBV-DNA (nested PCR for s, c and x regions).

Results: Anti-HCV was detected among 40/49 (81.6%) children with haematological disorders (24/49; 49% HCV-RNA positive) and 9/51 (17.6%) children with malignancies (12/51; 23.5% HCV-RNA positive). HBV-DNA was positive among 38%; positive c region in 33% (15/49 and 18/51 children with haematological disorders and malignancies respectively), s region in four leukaemics and x region in one leukaemic. Twenty-one patients had occult HBV infection; one (2.6%) was HBeAg positive, four (19%) total HBcAb positive, 20 (95.2%) c region HBV-DNA positive and one was s region positive (1/21; 4.8%). HCV-RNA was the significant predictor for occult HBV (P<0.05), with an increased frequency of HBV-DNA in the HBsAg negative (HCV-RNA positive) (63.2%) compared with patients negative for HCV-RNA (25%) (P=0.009).

Conclusion: Occult HBV infection is not uncommon in transfused immunocompromised children with chronic HCV infection. Nucleic acid amplification should be considered in screening donors as post-transfusion hepatitis B viraemia may be substantial.

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