Children with congenital immune defects – a high-risk group for blood-borne infections (hepatitis B and C)
- Authors: Satsuk A.V.1,2, Solopova G.G.1, Rodina Y.A.1, Novichkova G.A.1, Ploskireva A.A.2, Аkimkin V.G.2
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Affiliations:
- Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology
- Central Research Institute of Epidemiology
- Issue: Vol 15, No 2 (2025)
- Pages: 50-54
- Section: Original Investigations
- URL: https://journals.rcsi.science/2226-6976/article/view/314501
- DOI: https://doi.org/10.18565/epidem.2025.15.2.50-54
- ID: 314501
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Abstract
Objective. Determination of the risk factors for hepatitis B (HB) and C (HC) infection in patients with congenital immune defects (CID), a high-risk group among patients treated in pediatric oncohematology departments and clinics.
Materials and methods. The study included 1,587 patients with CID, aged 0 to 18 years, admitted to the Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology in the period from 2014 to 2022 to undergo diagnostic and therapeutic procedures that are not available in regional clinics. Among them, there were 37 patients with HCV and 40 with HBV. For the assessment of the invasive burden and comparison, 5 clinical groups were identified: patients with CID, benign blood diseases (BBD), hemoblastoses (HB), solid malignant tumors (SMT), benign neoplasms (BN). The invasive load was assessed in 500 patients (100 from each clinical group, patients were selected randomly). The invasive load was assessed by the level of infusion load (the number of parenteral drugs administered), the frequency of diagnostic blood sampling, the number of blood doses and its components, the number of surgeries, bone marrow and lumbar punctures, diagnostic endoscopic studies with counting the number of manipulations per 1 patient per day. The median was calculated to assess the invasive load.
Results. Patients with CID were the group with the highest risk of contracting blood-borne infections among clinical groups of patients: HBV infection incidence among them was 2.5% (12.5 times higher than in patients with SMT, 3.1 times higher than in HB, 2.8 times higher than in BBD, 62,5 times higher than in BN), HCV - 2.3% (1.9, 1.8, 1.8 and 3.8 times higher, respectively). Patients with CID were characterized by the lowest invasive burden: 2.2 interventions per day per 1 patient, which was 5 times less than in patients with HB, 2.8 times less than in patients with SMT, 2.3 times less than in patients with BBD, 1.9 times less than in patients with BN. The medians of invasive interventions for patients with CID were positive only for infusion load and diagnostic blood sampling, but were lower than in patients with HB (the group with the highest invasive load), by 14 and 1.3 times, respectively. The invasive load in patients with CID in a specialized hospital setting was low, but during the long-term diagnostic search for their primary diagnosis, accompanied by frequent hospitalizations due to infectious diseases, children were exposed to a long-term massive invasive load in conditions not intended for immunocompromised patients.
Conclusion. The leading risk factor for infection with HBV and HCV in children with CID is the impact of unsafe invasive factors, such as parenteral drug administration and diagnostic blood sampling. Deficiency of the T-cell link of immunity, characteristic of such patients, is of no small importance.
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##article.viewOnOriginalSite##About the authors
Anastasia V. Satsuk
Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology; Central Research Institute of Epidemiology
Email: vnpoemp2@yandex.ru
ORCID iD: 0000-0003-3293-2008
Cand. Med. Sci., Epidemiologist, Head of the Department for Advanced Training of Nursing Staff; Senior Researcher
Russian Federation, Moscow; MoscowGalina G. Solopova
Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology
Email: galina.solopova@fccho-moscow.ru
ORCID iD: 0000-0002-1680-7269
Cand. Med. Sci., Hematologist, Deputy Chief Physician for Infection Control
Russian Federation, MoscowYulia A. Rodina
Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology
Email: yulia.rodina@fccho-moscow.ru
ORCID iD: 0000-0001-9857-4456
Cand. Med. Sci., Allergist-Immunologist, Head of the Immunology Department
Russian Federation, MoscowGalina A. Novichkova
Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology
Email: Galina.Novichkova@fccho-moscow.ru
ORCID iD: 0000-0003-4911-0553
МD, Professor, Scientific Director
Russian Federation, MoscowAntonina A. Ploskireva
Central Research Institute of Epidemiology
Email: antoninna@mail.ru
ORCID iD: 0000-0002-3612-1889
МD, Professor, Deputy Director for Clinical Work
Russian Federation, MoscowVasily G. Аkimkin
Central Research Institute of Epidemiology
Author for correspondence.
Email: vgakimkin@yandex.ru
ORCID iD: 0000-0003-4228-9044
Academician of the Russian Academy of Sciences, МD, Professor, Director
Russian Federation, MoscowReferences
- Сацук А.В., Солопова Г.Г., Плоскирева А.А. Систематический обзор вспышек гемоконтактных инфекций (гепатит В, С, ВИЧ), передающихся от пациента к пациенту при оказании медицинской помощи. Журнал микробиологии, эпидемиологии и иммунобиологии 2021; 98(3): 319–330. doi: 10.36233/0372-9311-1125. Satsuk A.V., Solopova G.G., Ploskireva A.A. [A systematic review of outbreaks of bloodborne infections (hepatitis B and C, HIV) transmitted from patient to patient in healthcare settings]. Journal of Microbiology, Epidemiology and Immunobiology 2021;98(3): 319–330. (In Russ.). doi: 10.36233/0372-9311-1125
- Сацук А.В., Солопова Г.Г., Плоскирева А.А., Акимкин В.Г., Новичкова Г.А. Значение факторов риска заражения вирусными гепатитами B и C у детей с онкогематологическими заболеваниями и иммунодефицитными состояниями. Анализ риска здоровью 2024; (1): 100–110. doi: 10.21668/health.risk/2024.1.10. Satsuk A.V., Solopova G.G., Ploskireva A.A., Akimkin V.G., Novichkova G.A. [The significance of risk factors for acquiring hepatitis B and C virus infections in children with oncological and hematological diseases and immunodeficiencies]. Health Risk Analysis 22024; (1): 100–110. (In Russ.). doi: 10.21668/health.risk/2024.1.10
- Сацук А.В., Солопова Г.Г., Плоскирева А.А., Акимкин В.Г. Систематический обзор серопревалентности маркеров гепатита В, С и ВИЧ среди пациентов онкогематологического профиля. Клиническая микробиология и антимикробная химиотерапия 2023; 25(2): 131–141. doi: 10.36488/cmac.2023.2.131-141. Satsuk A.V., Solopova G.G., Ploskireva A.A., Akimkin V.G. [Systematic review of seroprevalence of markers of hepatitis B, C and HIV among oncohematological patients]. Clinical microbiology and antimicrobial chemotherapy 2023; 25(2): 131–141. (In Russ.). doi: 10.36488/cmac.2023.2.131-141
- Гармаева Т.Ц., Куликов С.М., Михайлова Е.А., Судариков А.Б., Филатов Ф.П., Савченко В.Г. Вирусные гепатиты В и С у больных гемобластозами и депрессиями кроветворения. Гематология и трансфузиология 2012; приложение: 6–7. Garmaeva T.C., Kulikov S.M., Mihailova E.A., Sudarikov A.B., Filatov F.P., Savchenko V.G. [Viral hepatitis B and C in patients with hemoblastoses and hematopoietic depressions]. Russian journal of hematology and transfusiology 2012; appendix: 6–7. (In Russ.).
- Mohamoud Y.A., Mumtaz G.R., Riome S., Miller D., Abu-Raddad L.J. The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis. BMC Infect. Dis. 2013; 13: 288. doi: 10.1186/1471-2334-13-288
- Cunningham-Rundles C., Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clin. Immunol. 1999; 92(1): 34–48. doi: 10.1006/clim.1999.4725
- Chapel H.M., Christie J.M., Peach V., Chapman R.W. Five-year follow-up of patients with primary antibody deficiencies following an outbreak of acute hepatitis C. Clin. Immunol. 2001; 99(3): 320–324. doi: 10.1006/clim.2001.5036
- Bjøro K., Frøland S.S., Yun Z., Samdal H.H., Haaland T. Hepatitis C infection in patients with primary hypogammaglobulinemia after treatment with contaminated immune globulin. N. Engl. J. Med. 1994; 331(24): 1607–1611. doi: 10.1056/NEJM199412153312402
- Razvi S., Schneider L., Jonas M.M., Cunningham-Rundles C. Outcome of intravenous immunoglobulin-transmitted hepatitis C virus infection in primary immunodeficiency. Clin. Immunol. 2001; 101(3): 284–288. doi: 10.1006/clim.2001.5132.
- Абрамова И.Н., Родина Ю.А., Щербина А.Ю. Эволюция препаратов внутривенных иммуноглобулинов и их клинического применения в педиатрической практике. Педиатрия 2019; 98(4): 210–217. doi: 10.24110/0031-403X-2019-98-4-210-217. Abramova I.N., Rodina Yu.A., Shcherbina A.Yu. [Evolution of intravenous immunoglobulin preparations and their clinical use in pediatric practice]. Pediatrics 2019; 98(4): 210–217. (In Russ.). doi: 10.24110/0031-403X-2019-98-4-210-217
- Islam N., Krajden M., Gilbert M., Gustafson P., Yu A., Kuo M. et al. Role of primary T-cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort. J. Viral. Hepat. 2017; 24(5): 421–429. doi: 10.1111/jvh.12650
- Ладная Н.Н., Дементьева Л.А., Курганова О.П., Плоскирева А.А., Пименов Н.Н., Бурдинская Е.Н. и др. Эпидемиологическое расследование случаев инфицирования детей вирусным гепатитом С в онкогематологическом отделении медицинской организации. Эпидемиол. инфекц. болезни. Актуал. вопр. 2022; 12(4): 52–56. doi: 10.18565/epidem.2022.12.4.52-60. Ladnaia N.N., Dementyeva L.A., Kurganova O.P., Ploskireva A.A., Pimenov N.N., Burdinskaya E.N. et al. [Epidemiological investigation of infection cases in children with hepatitis C virus in the department of hematological oncology of the healthcare facility]. Epidemiоlоgy and infectious diseases. Сurrent items 2022; 12(4): 52–56. (In Russ.). doi: 10.18565/epidem.2022.12.4.52-60
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