Chronic hepatitis C virus infection in childhood: clinical patterns and evolution in 224 white children.
The characteristics and evolution of hepatitis C virus (HCV) infection were retrospectively investigated in a study of 224 HCV RNA-seropositive white children who were consecutively recruited at 7 European centers in 1980-1998. At presentation, all patients were positive for antibodies to hepatitis C virus, 87% were asymptomatic, and 48% had alanine aminotransferase (ALT) levels that were < or =2 times the upper limit of the range considered to be normal. Of 200 children followed for 1-17.5 years (mean follow-up +/- standard deviation [SD], 6.2+/-4.7 years), only 12 (6%) achieved sustained viremia clearance and normalization of the ALT level. In 92 revised liver biopsy specimen analyses, the mean fibrosis score (+/-SD) was 1.5+/-1.3 for children <15 years of age and 2.3+/-1.2 for children > or =15 years of age (range, 0-6 years; P<.01). Pediatric HCV infection is usually mild, but few patients, especially those who are perinatally infected, clear viremia in the medium-term follow-up. Conversely, the higher rates of fibrosis observed in older patients suggest the possibility of an insidious progression of HCV-associated liver disease.
Jara
Paloma
P
Hospital Infantil La Paz, Madrid, Spain.
Resti
Massimo
M
Hierro
Loreto
L
Giacchino
Raffaella
R
Barbera
Cristiana
C
Zancan
Lucia
L
Crivellaro
Carlo
C
Sokal
Etienne
E
Azzari
Chiara
C
Guido
Maria
M
Bortolotti
Flavia
F
D000293:Adolescent; D005075:Biological Evolution; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies