Serological markers of
hepatitis A, B, and Delta and human immunodeficiency viruses were studied in 25 children receiving
cancer chemotherapy. Eighty-eight percent had pre-existing HAV immunity which was unaltered by
chemotherapy. HDV
infection was observed in 8% while HIV was conspicuous by its absence. Active HBV
infection, observed in 76% of the children, was asymptomatic in the majority and was accompanied by a high incidence of HBe antigenaemia (57.9%) and its persistence. Pre-existing anti-HBs failed to prevent HBV
infection recurrence, which was, however, transient and self-limiting. Multiple
blood transfusions and repeated parenteral exposures appeared to be the possible sources of HBV acquisition. Transmission to close contacts was also observed. The study suggests that although HBV
vaccine might not be protective against HBV
infection in patients receiving
cancer chemotherapy, it may prevent its persistence and thereby help in reducing chronic
liver disease-related morbidity and a highly infectious reservoir. Strict HBV screening of blood donors, exclusive use of
disposable equipment, and vaccination of close contacts of
cancer patients is recommended, particularly in HBV endemic third-world countries.