Chronic Hepatitis C Virus Infection in Childhood: Clinical Patterns and Evolution in 224 White Children

Jara, Paloma; Resti, Massimo; Hierro, Loreto; Giacchino, Raffaella; Barbera, Cristiana; Zancan, Lucia; Crivellaro, Carlo; Sokal, Etienne; Azzari, Chiara; Guido, Maria; Bortolotti, Flavin
February 2003
Clinical Infectious Diseases;2/1/2003, Vol. 36 Issue 3, p275
Academic Journal
The characteristics and evolution of hepatitis C virus (HCV) infection were retrospectively investigated in a study of 224 HCV RNA-seropositive white children who were consecutively recruited at 7 European centers in 1980-1998. At presentation, all patients were positive for antibodies to hepatitis C virus, 87% were asymptomatic, and 48% had alanine aminotransferase (ALT) levels that were ≤2 times the upper limit of the range considered to be normal. Of 200 children followed for 1-17.5 years (mean follow-up ± standard deviation [SD], 6.2 ± 4.7 years), only 12 (6%) achieved sustained viremia clearance and normalization of the ALT level. In 92 revised liver biopsy specimen analyses, the mean fibrosis score (± SD) was 1.5 ± 1.3 for children < 15 years of age and 2.3 ± 1.2 for children ≥15 years of age (range, 0-6 years; P < .01). Pediatric HCV infection is usually mild, but few patients, especially those who are perinatally infected, clear viremia in the mediumterm follow-up. Conversely, the higher rates of fibrosis observed in older patients suggest the possibility of an insidious progression of HCV-associated liver disease.


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