Human Astrovirus among Children with Cancer in Basrah

Abstract

Background. The impairment of the T-lymphocyte system leads to reduced viral clearance, resulting in intensified disease and the possibility of prolonged infection.(2) The poor functioning of B lymphocytes makes the host susceptible to bacterial and viral infections, especially in cases of malignant disease. Aim of the study. The present study set out to determine the frequency of human astrovirus infection among patients who suffered from malignancies who were being treated in the Oncology Center of the Basrah Children’s Specialty Hospital. Patients and Method. A cross-sectional study was approved for a population of children with cancers during the period from October 1, 2015 through the end of January, 2016. Forty-five children (24 females and 21 males), all with cancers, were admitted to the Oncology Center of Basrah Children’s Specialty Hospital. Their ages ranged from under 1 year to 15 years. According to the results of a specially designed questionnaire, data were obtained from patients who were either symptomatic or asymptomatic for human astrovirus infections, including 3 newly diagnosed cases (before chemotherapy) and 38 cases (during chemotherapy), with the remaining 4 cases admitted after chemotherapy. Ninety stool samples were collected at day 0 and day 4 after admission, and all were tested using astrovirus antigen enzyme-linked immuno sorbent assay (ELISA) kits (EIA-4456). Results. On both days, the rate of astrovirus infections was 15.6% in the hospitalized children with cancers, and there were no statically significant differences between hematological malignancies and solid tumors (P value was 0.857). Among hematological malignancies, astrovirus was detected at a significant rate (the P value was 0.0001) in patients with acute myeloblastic leukemia, while patients with solid tumors exhibited significant expression of rhabdomyosarcoma (the P value was 0.001). Astrovirus infection was more prevalent in females (85.8%) than in males (the P value was 0.001). Infection was most prevalent in the age group of >1–5 years (57%), and most of the infected patients (85.8%) were from rural areas (the P value was 0.012). In most of the symptomatic infected cases (71.4%) the symptom was acute diarrhea (the P value was 0.05), and this was typically during chemotherapy. Conclusion. Astrovirus infections occur at significant rates in acute myeloblastic leukemia, among hematological malignancies, and in patients with rhabdomyosarcoma, in the solid-tumor category. Therefore, astrovirus screening should be done for all children with cancers, and especially for patients with acute myeloblastic leukemia or rhabdomyosarcoma. Keywords: Cancer in children, human astrovirus