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<p>Long-term childhood cancer survivors (CCS) are at increased risk for chronic hepatitis B (HBV) and hepatitis C (HCV) infections due to transfusions, invasive procedures, and immunosuppression. Despite improvements in blood safety and universal HBV vaccination, the burden of viral hepatitis in CCS from low- and middle-income countries (LMICs), including India, remains under-characterized.To determine the prevalence and clinical spectrum of chronic HBV and HCV infections among long-term CCS at a tertiary care centre in India. Methods: In this retrospective study, 527 CCS treated between 1997 and 2017 were screened for HBsAg and anti-HCV antibodies during follow-up at our After Completion of Therapy (ACT) clinic. Confirmatory and relevant investigations (HBV DNA PCR, HCV RNA PCR, fibroscan) were performed in seropositive patients. Management was guided by WHO guidelines, and patients were monitored longitudinally. Nineteen CCS (3.6%) were seropositive: 11 for HBV, 7 for HCV, and 1 for both. Majority had history of transfusions (76%) and invasive procedures (100%). Among HBV-positive patients, three had persistent viremia despite treatment and compliance was a challenge. All HCV-positive patients received direct-acting antiviral therapy. No patient showed evidence of fibrosis, cirrhosis, or hepatocellular carcinoma at a median follow-up of 11-years. Despite improvements in transfusion safety and immunization, a subset of CCS remain at risk for chronic HBV and HCV infections. Proactive long-term surveillance and timely antiviral therapy are critical to preventing liver-related morbidity. Routine viral hepatitis screening should be an integral component of survivorship care in low- middle-income countries (LMICs).</p>

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Spectrum of Chronic Hepatitis B and C Infection in Long-Term Survivors of Childhood Cancer

  • 期刊论文

  • 发表日期：

    2026年1月10日

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  • Jeevan Reddy,
  • Arpit Mittal,
  • Sandeep Jain,
  • Payal Malhotra,
  • Gauri Kapoor

摘要

Long-term childhood cancer survivors (CCS) are at increased risk for chronic hepatitis B (HBV) and hepatitis C (HCV) infections due to transfusions, invasive procedures, and immunosuppression. Despite improvements in blood safety and universal HBV vaccination, the burden of viral hepatitis in CCS from low- and middle-income countries (LMICs), including India, remains under-characterized.To determine the prevalence and clinical spectrum of chronic HBV and HCV infections among long-term CCS at a tertiary care centre in India. Methods: In this retrospective study, 527 CCS treated between 1997 and 2017 were screened for HBsAg and anti-HCV antibodies during follow-up at our After Completion of Therapy (ACT) clinic. Confirmatory and relevant investigations (HBV DNA PCR, HCV RNA PCR, fibroscan) were performed in seropositive patients. Management was guided by WHO guidelines, and patients were monitored longitudinally. Nineteen CCS (3.6%) were seropositive: 11 for HBV, 7 for HCV, and 1 for both. Majority had history of transfusions (76%) and invasive procedures (100%). Among HBV-positive patients, three had persistent viremia despite treatment and compliance was a challenge. All HCV-positive patients received direct-acting antiviral therapy. No patient showed evidence of fibrosis, cirrhosis, or hepatocellular carcinoma at a median follow-up of 11-years. Despite improvements in transfusion safety and immunization, a subset of CCS remain at risk for chronic HBV and HCV infections. Proactive long-term surveillance and timely antiviral therapy are critical to preventing liver-related morbidity. Routine viral hepatitis screening should be an integral component of survivorship care in low- middle-income countries (LMICs).