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Annals of Oncology 4:229-234, 1993
© 1993 European Society for Medical Oncology

research-article

Late seroconversion and high chronicity rate of hepatitis C virus infection in patients with hematologic disorders

A. Gruber1,, H. Norder2, L. Magnius2, M. Rotzén3, C. Rubio4, L. Grillner3 and M. Björkholm1

1Division of Medicine, Section of Hematology and Immunology
2National Bacteriological Laboratory
3Department of Clinical Microbiology, Section of Virology
4Department of Pathology, Karolinska Hospital Stockholm, Sweden

Astrid Gruber, M.D. Division of Medicine, Section of Hematology and Immunology, Karolinska Hospital, 10401 Stockholm, Sweden

BACKGROUND: Patients with hematologic disorders requiring repeated blood and platelet transfusions are at high risk for development of post-transfusion non-A, non-B hepatitis.

PATIENTS AND METHODS: Fifty-five patients with hematologic diseases and post-transfusion non-A, non-B hepatitis were studied. Sera were assayed for hepatitis C virus (HCV) antibodies with a second-generation enzyme-linked immunoassay. Sera from 40 patients were examined for the presence of HCV RNA with a nested PCR method.

RESULTS: The clinical picture of acute non-A, non-B hepatitis did not differ from that described in other patient groups: however, progression to chronic hepatitis was very common (95%). Thirty-eight (95%) of 40 patients, whose sera were analysed both serologically and for the presence of HCV RNA had verified HCV infections. In some patients time to seroconversion was prolonged, up to more than 14 months. Seventeen patients with resistant or relapsed acute leukemia were treated with combination chemotherapy during the acute or chronic phase of hepatitis. Suppression of the inflammatory activity as reflected by a decrease of serum aminotransferase levels was recorded during the subsequent pancytopenic period.

CONCLUSIONS: Hepatitis C has a high chronicity rate in patients with hematologic disorders which parallels the situation of hepatitis B in the immunocompromised host. Furthermore, like the situation in hepatitis B, the hosts' immune response to infection seems to be involved in the pathogenesis of liver injury. Time to seroconversion may be prolonged and detection of HCV RNA is therefore important for diagnosis.

immunosuppression, hematologic diseases, hepatitis C, chronic active hepatitis, non-A and non-B hepatitis


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