title: Spontaneous remission of chronic hepatitis C in children.
abstract: The clinical course of 48 children with chronic hepatitis C (33 boys, 15 girls; mean age: 12.2 years) was monitored for more than 3 years to clarify its natural course. All patients were positive for the second-generation antibody to hepatitis C virus (anti-HCV) and for serum hepatitis C virus (HCV) RNA. All but one patient had a history of blood transfusion. Serum levels of alanine aminotransferase (ALT) had been abnormal for more than 1.5 years. Spontaneous remission defined as a biochemical remission lasting more than 1 year in association with the disappearance of serum HCV RNA, occurred in 4 (8.3%), however, in 25%, HCV RNA was still detectable in the liver even after its disappearance from serum. In this patient, the level of antibody to HCV core antigen (anti-HCV core) did not decrease significantly and serum HCV RNA eventually reappeared. The serum titre of HCV RNA in the 4 children with spontaneous remission was lower than in the remaining 44 children. Spontaneous remission may occur in children with chronic hepatitis C in whom the serum titre of HCV RNA is low and serum level of anti-HCV core decreases significantly. Assessment of the intrahepatic HCV RNA is necessary to confirm complete remission.
  
  
  CONCLUSIONS
  A low serum titre of HCV RNA and a significant decrease in the serum titre of anti-HCV core were associated with spontaneous remission in children with chronic hepatitis C. Intrahepatic HCV RNA assessment is necessary to confirm complete remission.
authors.affiliation: Department of Paediatrics, National Defense Medical College, Tokorozawa-City, Saitama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fujisawa
authors.forename: H
authors.initials: H
authors.lastname: Komatsu
authors.forename: A
authors.initials: A
authors.lastname: Inui
authors.forename: Y
authors.initials: Y
authors.lastname: Miyagawa
authors.forename: M
authors.initials: M
authors.lastname: Onoue
authors.forename: I
authors.initials: I
authors.lastname: Sekine
authors.forename: S
authors.initials: S
authors.lastname: Yokota
authors.forename: R
authors.initials: R
authors.lastname: Hanada
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Inui
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000175:diagnosis*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D012075:Remission, Spontaneous
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral