title: Liver histology and alanine aminotransferase levels in children and adults with chronic hepatitis C infection.
abstract: BACKGROUND
  Chronic hepatitis C is often a mild disease in children, but whether this is related to younger age or shorter duration of infection is unclear. Histologic severity has been shown to correlate with duration of infection regardless of age.
  
  
  OBJECTIVE
  We compared histologic findings in children and adults with chronic hepatitis C while controlling for sex, duration of infection, hepatitis C virus (HCV)-RNA level, and genotype.
  
  
  METHODS
  Twenty-one children and 52 adults whose infection was less than 20 years in duration and who had undergone a liver biopsy were included. Two blinded liver pathologists reviewed the liver biopsies and scored inflammatory activity and fibrosis using the modified Knodell scoring system.
  
  
  RESULTS
  The groups were the same with respect to HCV-RNA level (P=0.8), and genotype (P=0.6) but differed in duration of disease (P=0.01) and sex composition (P=0.005). Covariate analysis showed no influence of genotype, duration of infection, or HCV-RNA level on outcome. In controlling for sex, children had significantly milder liver disease and alanine aminotransferase (ALT) elevations.
  
  
  CONCLUSIONS
  With equal duration of infection, HCV-RNA level, and genotype, children have lower serum ALT levels and less severe liver disease than adults infected with HCV.
authors.affiliation: Division of Gastroenterology and Nutrition, Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, WA 98195-6174, USA.
authors.forename: Karen F
authors.initials: KF
authors.lastname: Murray
authors.forename: Laura S
authors.initials: LS
authors.lastname: Finn
authors.forename: Shari L
authors.initials: SL
authors.lastname: Taylor
authors.forename: Kristy D
authors.initials: KD
authors.lastname: Seidel
authors.forename: Anne M
authors.initials: AM
authors.lastname: Larson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism*; D000704:Analysis of Variance; D002648:Child; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000201:enzymology* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000201:enzymology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis; D012367:RNA, Viral / Q000032:analysis; D012720:Severity of Illness Index; D013997:Time Factors; D019562:Viral Load
chemical_list: D012333:RNA, Messenger; D012367:RNA, Viral; D000410:Alanine Transaminase