Serologic, virologic, and histologic characteristics of chronic phase hepatitis C virus disease in children infected by transfusion.
OBJECTIVE
We studied the time course of hepatic dysfunction, seropositivity to hepatitis C virus (HCV) antibodies, viremia, and histologic evidence of hepatic injury to evaluate the course of HCV infection in children infected by blood transfusion.


METHODS
Twenty-nine patients (ages 4 to 18 years) who underwent open-heart surgeries for congenital heart disease were grouped into three categories based on alterations in serum alanine aminotransferase (ALT) levels: Group A, acute infection; Group B, subacute infection; and Group C, chronic infection.


RESULTS
In Group C, all 13 patients had detectable HCV RNA in serum. In contrast, all patients in Group A had no detectable HCV RNA: In Group B, one of nine patients had detectable HCV RNA and two of four patients examined had persistent chronic hepatitis by histologic criteria. Antibodies directed against C100-3 antigen or core-antigen were more useful than second-generation HCV antibody assays in determining the relationship between viremia and immunologic response. Infection with HCV genotype II and the presence of higher HCV RNA copy numbers were associated with histologic evidence of hepatic damage.


CONCLUSIONS
An abnormal ALT value is frequently associated with viremia, and biochemically resolved acute infection reflects clearance of HCV. However, a normal ALT does not always reflect an absence of hepatocyte damage and HCV replication in patients with subacute disease. The measures outlined in this study are useful indicators of disease activity during the chronic
Department of Pediatrics, University of Tokushima, School of Medicine, Japan.
S
S
Matsuoka
K
K
Tatara
Y
Y
Hayabuchi
Y
Y
Taguchi
K
K
Mori
H
H
Honda
S
S
Itou
Y
Y
Yuasa
Y
Y
Kuroda
D000208:Acute Disease; D000293:Adolescent; D000918:Antibody Specificity; D001707:Biopsy, Needle; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000097:blood*; D006526:Hepatitis C / Q000209:etiology / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D012367:RNA, Viral / Q000097:blood; D018709:Statistics, Nonparametric; D065227:Transfusion Reaction
D006508:Hepatitis Antibodies; D012367:RNA, Viral