Clinical picture and liver histology of chronic hepatitis C in children

摘要

BACKGROUND AND AIM: Chronic hepatitis C (CHC) is still a significant clinical problem because of not only a large proportion of infected individuals, but also unclear remote consequences of the disease. The aim of the study was to analyze the clinical course and the liver histology of CHC in children searching for potential influencing factors. METHODS: Sixty-eight children were enrolled into the study (mean, 13.34 [SD, 3.27] years). Medical records and a current clinical status of children were analyzed considering clinical symptoms, liver function tests, and qualitative and quantitative hepatitis C virus-RNA assay with genotype and liver histology. RESULTS: A parenteral route of infection concerned 98% of children; mean length of infection was 7.34 (SD, 4.03) years. Genotype 1a was found in 78% and 1b in 16.2% children. The history of malignancy was present in 74% of patients. The symptoms of liver cirrhosis with abnormal vein circulation were found in 2 children (3%). An increased alanine aminotransferase activity was detected in 62% of patients, whereas viral load less than 6 × 10 IU/mL was found in 56 children (82%). Histological evaluation of biopsy specimens showed moderate inflammatory activity (G2) and fibrosis (S2; mean, 2.0). Progression of fibrosis was proportional to the age at infection. CONCLUSIONS: The clinical course of CHC is usually mild but may result in the liver cirrhosis during childhood. Transient or constant increased alanine aminotransferase activity is observed in majority of children. Inflammatory activity and fibrosis have moderate progression in children and are proportional to the age at infection.