Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome.
OBJECTIVE
Little is known of hepatitis C virus (HCV) genotypes in HCV infected children. This retrospective, multicentre study investigated genotype distribution and correlation with clinical features and outcome in a large series of Italian children.


METHODS
Between 1990 and 2002, 373 HCV RNA positive children, consecutively recruited in 15 centres, were assayed for genotypes by a commercial line probe assay.


RESULTS
The following genotype distribution pattern was recorded: genotype 1b = 41%; 1a = 20%; 2 = 17%; 3 = 14.5%; 4 = 5%; other = 2.5%. The prevalence of genotypes 1b and 2 decreased significantly (p<0.001) among children born from 1990 onwards compared with older children (46% v 70%) while the rate of genotypes 3 and 4 increased significantly (from 8% to 30%). Children infected with genotype 3 had the highest alanine aminotransferase levels and the highest rate of spontaneous viraemia clearance within the first three years of life (32% v 3% in children with genotype 1; p<0.001). Of 96 children enrolled in interferon trials during the survey, 22% definitely lost HCV RNA, including 57% of those with genotypes 2 and 3.


CONCLUSIONS
HCV genotypes 1 and 2 are still prevalent among infected adolescents and young adults in Italy but rates of infection with genotypes 3 and 4 are rapidly increasing among children. These changes could modify the clinical pattern of hepatitis C in forthcoming years as children infected with genotype 3 have the best chance of spontaneous viraemia clearance early in life, and respond to interferon in a high proportion of cases.
Bortolotti
F
F
Clinica Medica 5, Via Giustiniani 2, 35100 Padova, Italy. flavia.bortolotti@unipd.it
Resti
M
M
Marcellini
M
M
Giacchino
R
R
Verucchi
G
G
Nebbia
G
G
Zancan
L
L
Marazzi
M G
MG
Barbera
C
C
Maccabruni
A
A
Zuin
G
G
Maggiore
G
G
Balli
F
F
Vajro
P
P
Lepore
L
L
Molesini
M
M
Guido
M
M
Bartolacci
S
S
Noventa
F
F
D000293:Adolescent; D000410:Alanine Transaminase / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000235:genetics* / Q000635:transmission; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies
D012367:RNA, Viral; D000410:Alanine Transaminase