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

• Published in: Liver international Vol. 29; no. 4; pp. 518 - 524
• Main Authors: Said, Zeinab N.A., El-Sayed, Manal H., El-Bishbishi, Iman A., El-Fouhil, Daad F., Abdel-Rheem, Soad E., El-Abedin, Maha Z., Salama, Iman I.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2009
• Subjects: Adolescent; Case-Control Studies; Child; Child, Preschool; Comorbidity; DNA, Viral - analysis; Egypt - epidemiology; Female; haematological diseases; HBV/HCV co-infection; Hematologic Neoplasms - blood; Hematologic Neoplasms - epidemiology; Hematologic Neoplasms - virology; Hepacivirus - genetics; Hepacivirus - immunology; Hepatitis B - complications; Hepatitis B - epidemiology; Hepatitis B - transmission; Hepatitis B Antibodies - blood; Hepatitis B virus; Hepatitis B virus - genetics; Hepatitis B virus - immunology; Hepatitis C - complications; Hepatitis C - epidemiology; Hepatitis C Antibodies - blood; Hepatitis C virus; Humans; Immunocompromised Host; Infant; Male; occult hepatitis B; Prevalence; RNA, Viral - analysis; Seroepidemiologic Studies; transfusion; Transfusion Reaction
• ISSN: 1478-3223; 1478-3231; 1399-1698
• DOI: 10.1111/j.1478-3231.2009.01975.x

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.