title: Bone disorders in children and adolescents with chronic HCV infection.
abstract: OBJECTIVE
  Although several studies have demonstrated a higher incidence of bone disorders in HCV-infected adults, the bone turnover alterations occurring in children and adolescents with chronic hepatitis C has not been thoroughly focused yet. We performed a study on a cohort of 30 HCV infected caucasian children and adolescents to assess the prevalence of osteodystrophy and evaluate a possible prophylactic and therapeutic approach.
  
  
  METHODS
  Data regarding biochemical markers of bone metabolism were collected. Moreover, results of ultra-sonographic bone densitometry yearly performed were evaluated in comparison with data obtained from more than 500 healthy children and adolescents.
  
  
  RESULTS
  Osteocalcin and telopeptide of the collagen molecule type-1, CTX, appeared higher than normal in 8/30 and in 7/30 cases respectively; the 25OH vitamin D values were normal in 25/28 cases. By densitometry osteoporosis was detected in 2 patients and osteopenia in other 5. After stratification of cases by age groups, the incidence of osteopenia/osteoporosis appeared higher among children than among adolescents. Osteocalcin levels tended to be higher in cases where hepatic fibrosis were not detected.
  
  
  CONCLUSIONS
  The higher number of cases of osteopenia/osteoporosis in children than in adolescents is worthy of note, although not statistically significant. Ultrasound densitometry confirmed its important early diagnostic role in asymptomatic HCV infected children; moreover, also the increase in serum levels of osteocalcin may be considered as early marker of osteodystrophy of complementary value. Larger studies will be needed to confirm the efficacy and safety of antiviral and supportive care in these patients.
authors.affiliation: Department of Infectious Diseases, "Fondazione IRCCS Policlinico San Matteo", University of Pavia, Pavia, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Maccabruni
authors.affiliation: Department of Infectious Diseases, "Fondazione IRCCS Policlinico San Matteo", University of Pavia, Pavia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zaramella
authors.affiliation: Department of Orthopaedics and Traumatology, "Città di Pavia Institute", University of Pavia, Pavia, Italy.
authors.forename: Luisella
authors.initials: L
authors.lastname: Pedrotti
authors.affiliation: Department of Orthopaedics and Traumatology, "Città di Pavia Institute", University of Pavia, Pavia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Lucanto
authors.affiliation: Department of Electrical, Computer and Biomedical Engineering (ECBE), University of Pavia, Pavia, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Quaglini
authors.affiliation: Department of Orthopaedics and Traumatology, "Città di Pavia Institute", University of Pavia, Pavia, Italy.
authors.forename: Redento
authors.initials: R
authors.lastname: Mora
keywords: bone disorders; childhood; chronic HCV infection