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Hepatitis C common in some childhood cancer survivors
  NEW YORK (Reuters Health) - Many children with cancer who received contaminated blood products before hepatitis C virus (HCV) screening began in 1992 continue to be dogged by the disease, researchers report. Overall, "adverse outcomes do not yet exceed that seen in most adult cohorts, although the tempo of disease does appear accelerated," the investigators find.
In a study that began in 1995, Dr. Melissa Hudson of St. Jude Children's Research Hospital, Memphis and colleagues have been following 122 children with such transfusion-acquired HCV. Their median age is currently about 29 years.
At enrollment, 81.1% showed chronic infection, mainly with genotype 1 HCV. Liver biopsy in 60 of the patients at a median of 12.4 years after cancer diagnosis showed that 28.8% had mild fibrosis, 35.6% had moderate fibrosis and the remaining 13.6% had cirrhosis.
As reported in the April 1st issue of Blood, 20% of those surveyed reported having health problems and complaints so severe that they made daily living difficult or impaired some or all of the time.
The researchers observe that a variety of antiviral treatments have led to clearance of HCV in 17 (44%) of the 38 patients treated to date. This response rate is similar to that seen in other patients with chronic HCV.
Six patients have died so far. One death was due to variceal bleeding in a patient with decompensated cirrhosis, two were from accidents and the others were from aspiration, heart disease or a second cancer.
Blood 2004;103:2460-2466.


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