Specifics of viral hepatitis c in children with acute lymphoblastic leukemia

Abstract

Introduction: Viral hepatitis C (HCV) is one of the most common disease that is characterized by severe consequences, including the rapid progression of liver dysfunction due to cirrhosis and development of primary liver cancer - hepatocellular carcinoma. Materials and Methods: We analyzed 75 medical cards of patients with diagnosis "Acute Lymphoblastic Leukemia" during 2013-2015.Discussion results: We found that among patients HCV infection was found in 50 cases (66.66%) of them - 4 suffered from acute viral hepatitis C (5.33%) and 46 - with chronic hepatitis C (61.33%). Among patients with ALL and HCV infection there was a division of the level of transaminases in the blood: 3 patients - the level of ALT and AST was in the normal range (6%) 12 - had increased level of ALT and AST in 2 times ( 24%), 18 - in 3-5 times (36%), 11 - in 5-9 times (22%) and 6 - in 10 and more times (signs of toxic hepatitis) (12%). According to the literature (V. Berezenko “Clinical and paraclinical aspects of chronic viral hepatitis C in children”//Perynatology and pediatrics 2(62), 2015) in HCV patients without comorbidity was observed following distribution: 28 patients (43.75%) - normal levels of transaminases, 20 (31.25%) - increased in 2 times, 16 (25 %) - in 3-5 times, 0 – increased in 5 - 9 times, 0 – in more than 10 times. In patients with ALL and HCV statistically significant (p <0,05) that level of transaminases was higher than in patients without ALL, indicating a greater severity of cytolytic syndrome in children with ALL and HCV. In patients who were treated with chemotherapy, but not infected with HCV there was not observed expressed cytolytic syndrome. Conclusions: In patients which suffer from ALL and HCV was observed more expressed cytolytic syndrome (increased ALT and AST) than in patients with HCV without comorbidity. In patients with ALL without concomitant HCV was not observed cytolytic syndrome during PCT treatment. Thus, the HCV infection causes more expressed liver injury in the presence of comorbidity, in this case, ALL, and increases the risk of toxic hepatitis in patients with ALL during PCT treatment.