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

Authors


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

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.

Ancillary