An updated follow‐up of chronic hepatitis C after three decades of observation in pediatric patients cured of malignancy

Background The aim of the study was to evaluate the clinical characteristics and the long‐term outcome of chronic hepatitis C in a cohort of Caucasian children cured of pediatric malignancy. Procedure The study population included 83 consecutive patients, referred to our Center with a diagnosis of leukemia/lymphoma (50) or solid tumors (33) between 1977 and 1989 and infected with hepatitis C virus (HCV) during chemotherapy. Results At enrollment 77 subjects were HCV‐RNA positive. After a median follow‐up of 21 years (range 13–36), a sustained virological response (SVR) was obtained in 3 of 29 patients (10%) treated with interferon (IFN), in 1 of 3 patients (33%) treated with IFN and ribavirin, and in 5 of 11 patients (42%) treated with pegylated‐IFN and ribavirin ( P  = 0.03). Forty‐two patients remained untreated and only one (2.5%) cleared viremia. Four of 77 patients (5%) developed cirrhosis while other 4 patients died of causes not related to liver. At last follow‐up, 72% of HCV‐RNA positive patients had abnormal ALT. Conclusions In patients cured of pediatric malignancy chronic hepatitis C tends to run an indolent course during childhood and adolescence but more than 70% of treated and more than 80% of untreated cases children maintained HCV viremia. Moreover, after 2–3 decades of observation, 60% of HCV‐RNA positive patients had abnormal ALT and 5% had developed cirrhosis. Among treated patients, IFN or pegylated‐IFN and ribavirin obtained the higher rate of HCV‐RNA clearance. Pediatr Blood Cancer 2010;55:108–112. © 2010 Wiley‐Liss, Inc.