Chronic viral hepatitis in children: any role for the pathologist?

Guido, Maria; Bortolotti, Flavia

doi:10.1136/gut.2007.139410

Cited by 15 publications

(16 citation statements)

References 80 publications

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“…Available data suggest an association between the duration of infection and fibrosis progression [1,12,16,20,24]. The same observation was made in our study: duration of infection (but not age at liver biopsy or age at acquisition of infection) was an independent positive predictor of fibrosis.…”

Section: Considering a Strong Correlation Between Alt And Ast (R = 0supporting

confidence: 89%

“…The stage of the fibrosis was assessed using a 5-point scale: 0 -no fibrosis; 1 -portal fibrosis, fibrous portal expansion; 2 -periportal fibrosis, periportal or scarce portal-portal septa; 3 -septal fibrosis, fibrous septa with architectural distortion; and 4 -cirrhosis. In addition, the presence of the three histopathological lesions typical for chronic hepatitis C in adults was analyzed: portal lymphoid aggregates/follicles, steatosis and bile duct damage [12,13,14].…”

Section: Liver Biopsymentioning

confidence: 99%

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Determinants of liver disease progression in children with chronic hepatitis C virus infection

Pokorska‐Śpiewak¹,

Kowalik-Mikołajewska²,

Aniszewska³

et al. 2015

pjp

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Section: Considering a Strong Correlation Between Alt And Ast (R = 0supporting

confidence: 89%

Section: Liver Biopsymentioning

confidence: 99%

Determinants of liver disease progression in children with chronic hepatitis C virus infection

Pokorska‐Śpiewak¹,

Kowalik-Mikołajewska²,

Aniszewska³

et al. 2015

pjp

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“…However, the data regarding factors influencing liver disease progression in HBV-infected patients is inconsistent [5,6,[17][18][19]. Chronic viral hepatitis acquired in childhood is considered as a long-lasting process based on various host-virus interactions with a number of factors related to the virus (genotype, viral load), to the host (immunocompetence, hormonal status, co-infections, therapy) and to the environment (alcohol, drugs), which may interfere with the natural history of the disease [6,13,17]. In adult patients, the long-term risk for both cirrhosis and HCC is directly correlated to HBeAg positivity and serum HBV DNA viral load [6].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, non-invasive tests have not been fully validated in pediatric patients with CHB. Therefore, at present, no sufficient data is available in children and, therefore, these non-invasive methods cannot be a substitute for a liver biopsy in the decision to start treatment of CHB in pediatric patients [2,13].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Liver Disease Severity in Children with Chronic Hepatitis B

et al. 2016

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Background. Evaluation of the liver histology is essential for the management of chronic hepatitis B (CHB) in children.Objectives. The aim of this study was to analyze the histopathological features in children with CHB and compare them with clinical and laboratory data. Material and Methods. The study comprised 30 treatment-naïve children (mean age: 12.8 ± 2.4; mean duration of infection: 11.7 ± 2.5 years; 16/30 HBeAg-positive and 14/30 HBeAg-negative), who underwent a liver biopsy due to CHB. Liver biopsies were evaluated according to the modified Knodell score. Results. A histopathological evaluation revealed mild to severe necroinflammatory activity (mean grading: 5.4 ± 3.2) and fibrosis (mean staging: 1.7 ± 0.9), irrespective of the HBeAg-status, viral load and duration of infection. One case of cirrhosis was observed. A multiple regression analysis revealed that alanine and aspartate aminotransferase (ALT and AST) levels were associated with the necroinflammatory activity (p = 0.001 for ALT, and p = 0.006 for AST). No such correlation for fibrosis was observed; however, children with elevated AST were prone to more advanced fibrosis compared to children with normal AST level (p = 0.01). Conclusions. Children with CHB presented a wide range of liver changes over a decade after the infection. The severity of liver lesions did not differ according to the HBeAg status, viral load and duration of the infection. ALT and AST levels correlated positively with the inflammatory activity. AST seems to be a better predictor of fibrosis compared to ALT. Liver biopsy is a useful tool in evaluating the severity of liver disease in children with chronic hepatitis B, whereas clinical and laboratory parameters are weak predictors of liver injury (Adv Clin Exp Med 2016, 25, 4, 681-688).

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