Document Type : Research Article
Chronic hepatitis C (CHC) may be seen in cancer survivors due to frequent blood component therapy and parenteral exposures during treatment. Considering the long term adverse effects of CHC, the study was carried to evaluate the response of combination therapy (Pegylated Interferon and Ribavirin) in cancer survivors affected with CHC as direct acting antivirals have still not been approved for children below 12 years age.
Methods: This was a retrospective study carried in cancer survivors below 12 years, who had CHC. They were treated with combination of Pegylated interferon alpha2b 60mcg/m2/week and ribavirin 15mg/kg/day for 24 or 48 weeks for Genotypes 3 and 1 respectively. Rapid viral response (RVR) and sustained viral response (SVR) were evaluated by PCR at 4 weeks of starting therapy and after 24 weeks of completing therapy. Data on coinfection with Hepatitis B was also evaluated.
Results: Of the 32 patients, 21 were leukemia/lymphoma survivors and 11 were survivors of solid tumours. Genotype 1 was seen in 22/32(69%) and Genotype 3 in 10/32(31%). Hepatitis B co-infection was present in 6 (18.7%) patients. RVR (100% vs 45.5%) and SVR (100% vs 62%) were significantly higher for Genotype 3 as compared to Genotype 1. SVR for HCV was not significantly different in those with HBV coinfection as compared to those without.
Conclusion: Pegylated IFN and ribavirin combination therapy is a successful modality for treating CHC in age group <12 years in childhood cancer survivors where long term morbidities due to Hepatotropic viruses affect the quality of life.