Hepatitis C in childhood: epidemiological and clinical aspects.
Hepatitis C virus (HCV) is responsible for most cases of chronic non-A, non-B hepatitis in multi-transfused children, but has been also implicated in at least one third of cases without history of parenteral exposure. We have recently evaluated the natural history of chronic hepatitis C in 37 children without underlying systemic diseases. None of the patients had a history of acute hepatitis and only 22 were symptomatic at presentation. Liver histology was consistent with active liver disease of mild to moderate activity in 42% of cases (one child had cirrhosis) and with persistent or lobular hepatitis in the remaining cases. During a mean follow-up period of 3.4 +/- 3.2 years symptoms were rarely observed and none of the patients developed liver failure, but 97% maintained abnormal alanine-aminotransferase levels. These results suggest that chronic hepatitis C in children, at least in its early stage, is a mild disease infrequently associated with severe liver lesions; however the persistence of liver damage over the years raises questions about the long-term outcome of the illness and about the rationale of antiviral therapy.
Clin. Medica 2, Padua, Italy.
F
F
Bortolotti
P
P
Vajro
C
C
Barbera
R
R
Giacchino
P
P
Cadrobbi
L
L
Zancan
G
G
Nebbia
C
C
Crivellaro
A
A
Bertolini
L
L
De Moliner
D000208:Acute Disease; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005500:Follow-Up Studies; D006467:Hemophilia A / Q000453:epidemiology / Q000628:therapy; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006521:Hepatitis, Chronic / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D007938:Leukemia / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D013789:Thalassemia / Q000453:epidemiology / Q000628:therapy; D065227:Transfusion Reaction
D015415:Biomarkers; D000410:Alanine Transaminase