儿童急性白血病继发丙型病毒性肝炎

Secondary C virus infection after treatment of childhood acute leukemia

探讨儿童急性白血病继发输血后丙型病毒性肝炎的发生、发展及转归。方法 用RT PCR法测血清HCV RNA ,并用ELISA方法测HCV核心区多肽抗体 (HCV CP)。结果 10 7例儿童白血病中HCV感染率达 70 % (75 10 7) ;HCV CP检测阳性率明显低于HCV RNA(40 %vs74% ) ;HCV感染者化疗期间曾有转氨酶 (ALT)明显升高 ,但停止化疗后 5 0例中仅 1例ALT持续偏高 ,余均恢复正常 ,随访 0 .5a至 9a未发现肝功能失代偿表现。结论 儿童白血病继发HCV感染率高 ,但感染后多未呈进行性活动性肝炎表现 ,也未见肝功能失代偿发生 ;化疗期间HCV RNA检测优于HCV CP。

Department of Pediatrics, People′s Hospital,Attached to Beijing Medical University,Beijing 100044 Objective To investigate the prevalence, progression and prognosis of hepatitis C virus infection after treatment of acute leukemia children. Methods Serum HCV-RNA was assessed by RT-PCR and HCV-CP was evaluated by ELISA. Results Of 107 patients 75( 70%) were positive in HCV infected children,and the HCV-CP positive rate was much lower in HCV- RNA patients(40%vs 74%). During chemotherapy ATL was very high in HCV infected patients, but after the withdrawal of chemotherapy, ATL was persistently high only in one of the 50 patients, and that of the rest was almost normal. No patient developed symptoms of decompensated liver function over a period of 9 years'follow-up. Conclusion In this study, the prevalence of HCV infection was high in patients who had been treated for a childhood acute leukemia, but there was neither progressive active hepatitis manifestation nor severe liver impairment after infection, while during chemotherapy HCV- RNA was better than HCV-CP.