Non-A, non-B, non-C hepatitis: its significance in pediatric patients and the role of GB virus-C.
OBJECTIVE
To delineate the importance of non-A, non-B, non-C (non-ABC) hepatitis, and the role of GB virus C (GBV-C) in children.


METHODS
From 1980 to 1995, acute-onset viral hepatitis was diagnosed in 166 inpatients and categorized into type A, B, C, and non-ABC hepatitis according to the serologic markers or the results of polymerase chain reaction assay for HBV DNA or HCV ribonucleic acid (RNA) in the National Taiwan University Hospital. Non-ABC hepatitis was diagnosed in 57 patients (34%). GBV-C RNA was investigated by reverse transcription and nested polymerase chain reaction in 32 of the 57 patients with non-ABC hepatitis. The clinical and laboratory features of patients with acute non-ABC hepatitis were compared with the features of those with acute hepatitis A and B.


RESULTS
The degree of abnormality in aminotransferase activities was milder in patients with non-ABC hepatitis than in those with hepatitis B; chronicity was noted in 12%. Fulminant hepatitis occurred in 16%, and the mortality rate was 56%. Young age carried a significantly higher risk of having a fulminant course (1.9 +/- 0.2 years of age vs 6.4 +/- 5.1 years of age in acute course; p < 0.05). Compared with fulminant hepatitis B, fulminant non-ABC hepatitis had a trend of a longer interval from onset to death (119.2 +/- 144.8 vs 15.2 +/- 8.4 days; p = 0.079). GBV-C RNA was detected in only two of the patients tested, both of whom had received transfusions; one had persistent viremia and fluctuating aminotransferase values.


CONCLUSIONS
Non-ABC hepatitis plays an important role in the etiology of pediatric viral hepatitis; however, the role of GBV-C is minor. A search for other unknown viral agent(s) responsible for non-ABCG hepatitis is needed.
Lai
M W
MW
Department of Pediatrics, College of Medicine, National Taiwan University, Taipei.
Chang
M H
MH
Hsu
H Y
HY
D000208:Acute Disease; D002675:Child, Preschool; D002908:Chronic Disease; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D018067:Flaviviridae / Q000235:genetics; D006526:Hepatitis C / Q000201:enzymology / Q000401:mortality / Q000821:virology*; D016751:Hepatitis E / Q000201:enzymology / Q000401:mortality / Q000821:virology*; D006801:Humans; D008099:Liver / Q000201:enzymology; D008111:Liver Function Tests; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D015996:Survival Rate; D000637:Transaminases / Q000378:metabolism
D004279:DNA, Viral; D012367:RNA, Viral; D000637:Transaminases