Hepatitis B--a major threat to childhood survivors of leukaemia/lymphoma

Abstract

This prospective descriptive study was undertaken to determine: the proportion of paediatric oncology patients with prior exposure to hepatitis B at cancer diagnosis; the risk and risk factors for acquisition of hepatitis B infection during chemotherapy; and the development of a prevention policy. Sixty African children were included in this study. At the time of cancer diagnosis, 67.7 per cent had not been exposed to hepatitis B, and none had active infection. After follow-up (median of 20 months; range 4-81 months) 23.3 per cent had active hepatitis B infection, which was subclinical in the majority of cases. The diagnosis of leukaemia/lymphoma posed a major risk factor for the acquisition of active hepatitis B infection (chi-square 7.0; p-value = 0.008), probably due to intensive chemotherapy regimens and severity of immunosuppression. No association with gender, age, place of origin, or number of blood transfusions was found. Patients with leukaemia/lymphoma were at an increased risk for horizontal transmission of hepatitis B. A policy of active surveillance for infective carriers of hepatitis B infection and passive immunization of seronegative immunosuppressed patients must be implemented to limit the endemic infection in paediatric oncology units.