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BCG Treatment for Bladder Cancer and Hepatitis

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Li Liu, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
I was diagnosed with bladder cancer in 1990, and had two transuretheral removals of tumors. After the second recurrence I received BCG treatment and had good results. This year I was diagnosed with Hepatitis C.

A friend of mine, who is receiving the BCG treatment directed me to OncoLink Web site where he had read that one of the possible side effects to BCG may be Hepatitis. Not being a drug user I been wondering how I may have contracted the Hepatitis C virus. I was wondering if you could send me any information concerning the BCG treatments and how it may relate to me contracting Hepatitis C.  
Thank you,
MM

Li Liu, MD, Editorial Assistant for OncoLink, responds:

Dear M:
Thank you for your interest and question.

Hepatitis C virus can be detected in serum of infected individuals. The viral concentrations in other body fluids, e.g., saliva, semen, urine, stool, and vaginal secretions, are much lower or undetectable. Therefore, blood transfusion, either whole blood or component, is the most common route of transmission. Intravenous drug use and sexual transmission are the major routes of spread of hepatitis C virus.

Bacillus Calmette-Guerin (BCG) is a modified form of the tubercle bacillus. It is not a blood product, and does not transmit the hepatitis C virus. However, some case reports of granulomatous (non-viral) hepatitis have been reported to be associated with BCG therapy. Here are some of the reports.

• Granulomatous hepatitis following intravesical bacillus Calmette-Guerin therapy for bladder carcinoma
• A case of granulomatous hepatitis after intravesical bacillus Calmette-Guerin administration
• Granulomatous hepatitis as a complication of intravesical Bacillus Calmette-Guerin therapy for bladder carcinoma