Serological markers of hepatitis B virus (HBV), hepatitis C virus (HCV), human T-cell lymphotropic virus type 1 (HTLV-1), and human immunodeficiency viruses (HIV-1 and HIV-2) were studied in 53 Saudi children (31 males, 22 females; 1-12 years of age) receiving cycled cancer chemotherapy and in 168 healthy Saudi children taken as control. Exposure to HBV in the patients was similar to that in the control (6 per cent HBsAg in patients v. 7 per cent in the control; 19 per cent exposure rate in patients v. 20 per cent in control). None of our patients was vaccinated against HBV prior to chemotherapy. The fact that among the 10 HBV exposed patients five patients were anti-HBs-positive is in favour of vaccinating Saudi oncology patients against HBV prior to chemotherapy. In contrast to the situation with HBV the prevalence of anti-HCV in the patients (11 per cent) was significantly higher than that in the control (1 per cent) (P = 0.003). None of our patients or the control were anti-HTLV-1 or anti-HIV-positive. The results of this study stress the need for an awareness of HCV problem in Saudi oncology patients. Strict measures of screening blood donors for all blood-borne viruses and, in particular, for HCV in addition to the use of disposable equipment in management of cancer patients are items that should be implemented as soon as possible.

The efficacy of the combined immunoprophylaxis approach (passive plus active immunization) was evaluated in babies born to 52 HBsAg-carrier Saudi mothers, of whom seven (13.5%) were HBeAg-positive and seven were anti-HDV-positive. Newborns were given 100 IU of hepatitis B immune globulin (HBIG) from the Hepuman Berna-Swiss Serum and Vaccine Institute, Berne, and hepatitis B vaccine (5 micrograms) within 12 hours of birth, and the vaccine was given again at 1 and 6 months of age (5 micrograms/injection). After 18 months of follow-up, all but one baby had protective levels of antibody to HBsAg and none of the babies born to anti-HDV-positive carrier mothers showed evidence of HDV infection. These results show that the combined immunoprophylaxis approach is quite successful in protecting against perinatal transmission of HBV and HDV in the Saudi population. Furthermore, early vaccination against HBV will also protect against HDV infection later in life.

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