[Frequency and characteristics of hepatitis B infection in children with malignant diseases]

Hepatitis B, a complication of blood transfusion or other means of transmission, occurs with variable frequency in children with malignant diseases.

The objective of this study was to determine the frequency of hepatitis B virus infection in children with malignant diseases, to investigate the clinical course of the illness, and to analyse the influence of hepatitis on cytotoxic treatment.

The study included children diagnosed and treated for malignant diseases at the University Children's Hospital in Belgrade from 1997 to 2003. HBs Ag was analysed in all patients who had elevated transaminases of twice normal value, in children who had icterus, and in one group of patients treated routinely after 2001 before, during, and after therapy. RESULTS A total of 137 male and 107 female children who had malignancies were treated. From 113 children who were evaluated for the presence of HBs Ag at the beginning of treatment, 2 (1.7%) were HBsAg+. In this group of patients HBsAg was tested in 58 (51%) children during and after chemotherapy, and HBsAg was discovered in 17 (29%) of them. Of 123 children, in whom HBsAg was not tested at the beginning of their illness, 36 (55%) out of 66 (51%) tested patients were HBsAg+. No statistical difference between those two groups of patients was ascertained (chi2 = 3.27, p > 0.05). In summary, the presence of HBsAg was discovered in 53 patients, 22% out of 244 patients and 43% of tested patients. Nine patients had the icteric form of illness, with one case proving fatal due to fulminating hepatitis.

Taking into consideration the uncertain long-term prognoses of these patients, follow-up and treatment is essential.