title: Spontaneous clearance of hepatitis C virus in vertically infected children.
abstract: Spontaneous viral clearance of hepatitis C virus (HCV) has been reported to occur in children with vertical HCV infection. However, factors which are associated with or predispose for clearance are largely unknown. In this case series we retrospectively analyzed laboratory parameters associated with spontaneous clearance of HCV in vertically infected children. The charts of six patients with documented spontaneous viral clearance by the age of 5 years were reviewed regarding clinical course, liver function tests (LFTs) and trend of HCV gene copy numbers. Spontaneous viral elimination was observed between the 25th and 52nd months of age. All patients had elevated LFTs, which peaked before 20 months of life. Peak LFT elevation was followed by normalization of LFTs and decline in viral load. These findings suggest that, in vertically HCV-infected children, a potent inflammatory response in the liver precedes viral clearance. Therefore, temporarily elevated LFTs, followed by a decline of viral load may be indicative of a near viral clearance in early childhood.
  
  
  CONCLUSIONS
  Further investigations regarding the development of optimal treatment algorithms should take into account factors, which are associated with possible spontaneous viral resolution, such as viral genotype, favourable host factors as well as direct and indirect parameters of antiviral immunity, and the individual course of viral replication.
authors: Centre for Paediatrics and Adolescent Medicine, University of Freiburg, Freiburg, Germany.
authors: Susan
authors: S
authors: Farmand
authors: Stefan
authors: S
authors: Wirth
authors: Helga
authors: H
authors: Löffler
authors: Tanja
authors: T
authors: Woltering
authors: Sybille
authors: S
authors: Kenzel
authors: Elke
authors: E
authors: Lainka
authors: Philipp
authors: P
authors: Henneke
mesh_terms: D002675:Child, Preschool; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000276:immunology / Q000635:transmission / Q000821:virology*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008111:Liver Function Tests; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D012367:RNA, Viral