The significance of risk factors for acquiring hepatitis B and C virus infections in children with oncological and hematological diseases and immunodeficiencies
A.V. Satsuk1,2, G.G. Solopova1, A.A. Ploskireva2, V.G. Akimkin2, G.A. Novichkova1
1Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 1 Samory Mashela St., Moscow, 117997, Russian Federation
2Central Research Institute of Epidemiology, 3a Novogireevskaya St., Moscow, 111123, Russian Federation
Patients with oncological and hematological diseases are at high risk of nosocomial bloodborne infections (hepatitis B, hepatitis C, and HIV) due to their immunosuppressed condition and highly invasive treatment. The aim of our study is to identify the key risk factors of acquiring bloodborne infections among patients with hematological and oncological diseases and to determine the causes of uneven prevalence of hepatitis B and C among main clinical groups of patients.
The study was carried out from 2021 to 2023. The study cohort consisted of 500 patients, with 100 patients in each clinical group: primary immunodeficiencies PID), disorders of the blood and blood-forming organs (BD), hematological malignancies (HM), malignant solid tumors (MST), benign tumors (BT).
The median burden of invasive procedures per patient in the patients with HM, MST, BD, BT, and PID amounted to 10.9, 6.2, 5.1, 4.1, and 2.2 invasive interventions a day, respectively. The median infusion/injection burden was 8.3, 4.0, 2.7, 2.7, and 0.6 drugs a day, respectively. The median blood sampling burden amounted to 2.0, 1.7, 1.7, 1.3, and 1.6 samples a day, respectively. The median transfusion burden was 0.14, 0.07, 0.25, 0, and 0 units of transfused blood components a day, respectively. The median surgery burden was 0, 0.15, 0, 0.17, 0 surgical procedures a day, respectively. The medians for other medical procedures in all clinical groups amounted to 0.
The patients with PID representing a clinical group of patients with the highest prevalence of hepatitis B and C infections (2.5 % and 2.3 %, respectively) have the lowest level of invasive burden. It should be supposed that the major risk factor of acquiring HBV or HCV among patients with oncological and hematological diseases is the level of immunocompetence together with the impact of risk factors associated with invasive procedures such as blood transfusions, the use of venous catheters (for intravenous administration of drugs and blood sampling), and extensive surgeries.
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