HEPATITIS C IN CHILDHOOD CANCER SURVIVORS

儿童癌症幸存者中的丙型肝炎

• 批准号: 6514468
• 负责人: MELISSA M HUDSON
• 金额: $ 23.11万
• 依托单位: ST. JUDE CHILDREN'S RESEARCH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-15 至 2004-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6514468
• 关键词: blood transfusion; chronic disease /disorder; clinical research; disease /disorder etiology; disease /disorder model; disease /disorder onset; disease /disorder proneness /risk; epidemiology; hepatitis C; histology; human subject; immunosuppression; liver disorder; long term survivor; longitudinal human study; model design /development; outcomes research; pathologic process; pediatric neoplasm /cancer; prognosis

The broad, long-term objective of this proposal is to conduct a prospective, longitudinal natural history study of hepatitis C (HCV) infection in a well-defined cohort of childhood cancer survivors. The specific aims of this proposal are (1) to assemble a cohort of survivors of childhood cancer who were infected with HCV by transfusion during childhood, and (2) to develop predictive models for the subsequent development of cirrhosis, chronic active hepatitis, fibrosis, liver decompensation, hepatoma, hepatocellular carcinoma, and other HCV-related hepatic sequelae. This cohort is unique in comparison with other groups with chronic HCV infection in that these patients acquired the infection when they were young and were receiving immunosuppressive or hepatotoxic therapy. Thus, studies of this cohort should advance the understanding of clinical risk factors that predispose patients to clinically significant liver disease. So far, 1,441 of 3,767 (38.3 percent) patients who received transfusions at St. Jude Children's Research Hospital between 1962 and July 1992 have been screened for HCV by enzyme immunoblot assay. Of these, 110 (7.6 percent) patients have detectable HCV antibodies; 59 of these patients have been enrolled, and the remaining 51 are potentially eligible for participation in a longitudinal study of the natural history of HCV. Based on the prevalence of HCV infection in our currently screened cohort, we estimate that 293 transfused, but untested patients will be HCV seropositive. After adjusting for the anticipated rates of survival and study participation, we estimate that we will enroll a total of 268 HCV seropositive cancer survivors in a prospective epidemiologic study. As the ultimate aims of this proposal are to define the risk of progression to clinically significant liver disease in this cohort and to elucidate the impact of age, immunosuppression, and hepatotoxic cancer therapy on the outcome of chronic HCV infection, the histologic findings of these study patients will be correlated with clinical, laboratory, and diagnostic imaging variables.

该提案的广泛，长期目标是在定义明确的儿童癌症幸存者中对丙型肝炎（HCV）感染进行前瞻性的纵向自然史研究。 该提案的具体目的是（1）组装儿童癌症的一群幸存者，这些癌症在儿童期间通过输血感染了HCV，以及（2）为随后发展的肝硬化，慢性活性肝炎，纤维化，肝脏分解，肝瘤，肝癌，肝细胞瘤和其他HEP-RECLEAL和其他HEP-RCINSH和其他HEPELEN HEPEREL和其他HEPELEN HEPEREL和其他HEPELEN HEPEREL和其他HEPELEN和其他HEPEL和其他。 与其他患有慢性HCV感染的组相比，该队列是独一无二的，因为这些患者年轻时就会感染并接受免疫抑制或肝毒性疗法。 因此，对该队列的研究应提高人们对患者临床意义肝病的临床危险因素的理解。 到目前为止，在1962年至1992年7月之间在圣裘德儿童研究医院接受输血的3,767例（38.3％）的患者中有1,441例已通过酶免疫印迹测定法对HCV进行了筛查。 其中110名（7.6％）患者具有可检测的HCV抗体；这些患者中有59例已入学，其余51例有可能参与HCV自然史的纵向研究。 基于当前筛查的队列中HCV感染的患病率，我们估计293例转染，但未经测试的患者将是HCV血清阳性的。 在调整了预期的生存和研究参与率后，我们估计我们将在一项前瞻性流行病学研究中招募总共268个HCV血清阳性癌症幸存者。 由于该提议的最终目的是确定该队列中临床意义的肝脏疾病的风险，并阐明年龄，免疫抑制和肝毒性癌症治疗对慢性HCV感染结果的影响，这些研究患者的组织学发现与临床，实验室，实验室，实验室，诊断和诊断相关。