Hepatitis C virus infection in patients with leukemia.

We have studied 30 patients with acute leukemia by the second-generation assay for antibodies to hepatitis C virus (HCV) to determine the incidence of HCV infection and the impact of anti-HCV positivity on liver disease. After a complete remission, 21/30 (70%) patients were anti-HCV-positive. During chemotherapy the anti-HCV-positive patients had more severe liver disease than the anti-HCV-negative patients, and they had a higher incidence of chronic hepatitis (13/21; 62% vs. 1/9; 11%, P < 0.01). During subsequent follow-up, 15/30 (50%) patients relapsed and 15/30 (50%) patients completed the chemotherapy protocols. After a relapse 12/15 (80%) patients were anti-HCV-positive and they had more severe liver disease than the anti-HCV-negative patients. Among the patients who completed chemotherapy (n = 15), biochemical evidence of chronic hepatitis was found in 9/9 (100%) anti-HCV-positive, and 2/6 (33%) anti-HCV-negative cases during off-therapy follow-up after therapy-withdrawal (P < 0.05). These results indicate that HCV plays an important role in the etiology of chronic hepatitis which could worsen the final prognosis of successfully treated patients with leukemia.