title: Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome.
abstract: 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.
authors.affiliation: Clinica Medica 5, Via Giustiniani 2, 35100 Padova, Italy. flavia.bortolotti@unipd.it
authors.forename: F
authors.initials: F
authors.lastname: Bortolotti
authors.forename: M
authors.initials: M
authors.lastname: Resti
authors.forename: M
authors.initials: M
authors.lastname: Marcellini
authors.forename: R
authors.initials: R
authors.lastname: Giacchino
authors.forename: G
authors.initials: G
authors.lastname: Verucchi
authors.forename: G
authors.initials: G
authors.lastname: Nebbia
authors.forename: L
authors.initials: L
authors.lastname: Zancan
authors.forename: M G
authors.initials: MG
authors.lastname: Marazzi
authors.forename: C
authors.initials: C
authors.lastname: Barbera
authors.forename: A
authors.initials: A
authors.lastname: Maccabruni
authors.forename: G
authors.initials: G
authors.lastname: Zuin
authors.forename: G
authors.initials: G
authors.lastname: Maggiore
authors.forename: F
authors.initials: F
authors.lastname: Balli
authors.forename: P
authors.initials: P
authors.lastname: Vajro
authors.forename: L
authors.initials: L
authors.lastname: Lepore
authors.forename: M
authors.initials: M
authors.lastname: Molesini
authors.forename: M
authors.initials: M
authors.lastname: Guido
authors.forename: S
authors.initials: S
authors.lastname: Bartolacci
authors.forename: F
authors.initials: F
authors.lastname: Noventa
mesh_terms: 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
chemical_list: D012367:RNA, Viral; D000410:Alanine Transaminase