PREVALENCE AND MOLECULAR DETECTION OF HEPATITIS B AND HEPATITIS C VIRUS INFECTION IN CHRONIC MYELOID LEUKEMIA PATIENTS RECEIVING BCR-ABL TYROSINE KINASE INHIBITOR THERAPY

Abstract

Background: Tyrosine kinase inhibitors (TKIs) have improved the survival of patients with chronic myeloid leukaemia (CML), but prolonged treatment may affect immune function and increase the risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection or reactivation. Data on these viral infections in CML patients receiving TKI therapy in India are limited. Objectives: To assess the occurrence of HBV and HCV infection among BCR-ABL-positive patients receiving TKI therapy. Methods: This observational study was conducted at a tertiary care hospital in Jaipur, Rajasthan, from October 2024 to July 2026. Real-time RT-PCR for BCR-ABL was performed in 66 patients suspected of having Philadelphia chromosome-positive acute lymphoblastic leukaemia or CML. BCR-ABL-positive patients were tested for HBV and HCV at baseline and during follow-up after starting TKI therapy using third-generation ELISA and real-time PCR. Descriptive statistics were used for analysis. Results: BCR-ABL was detected in 51/66 patients (77.3%). All BCR-ABL-positive patients were negative for HBV and HCV at baseline. During follow-up, five patients (9.8%) developed HBV positivity and two (3.9%) developed HCV positivity, with no dual infections. Overall, 13.7% developed either HBV or HCV positivity during TKI therapy, and most infections occurred after treatment initiation. ELISA and PCR results showed complete agreement. Conclusions: HBV and HCV positivity occurred during TKI therapy despite negative baseline screening. Pre treatment screening and periodic monitoring may help detect infections early and support timely management in patients receiving TKI therapy.