Hepatitis C virus genotypes in chronic hepatitis C of children

Abstract

Several hepatitis C virus (HCV) genotypes have been recently identified and genotype 1b has been correlated with severe liver disease and a poor response to interferon therapy. HCV infection in children is an interesting model for evaluation of the relationship between HCV genotypes and liver disease, because of its relatively short duration and the infrequent association with confounding cofactors. We have investigated HCV genotypes, using a dot-blot hybridization assay with genotype-specific probes, in 36 Italian children with chronic hepatitis C who were otherwise well and had no other underlying disease. Only four patients were symptomatic; liver histology, obtained in 33 patients, showed minimal hepatitis in 17 and mild chronic hepatitis in 16. Infection with HCV genotype 1b was found in 55.5% of patients, with a peak prevalence of 83% in children from southern Italy (P < 0.05 vs other regions). The remaining children were infected with HCV genotype 1a (16.6%), genotype 2 (11.1%), and mixed (10.9%) or undetermined (2.7%) genotypes. In one patient, HCV viraemia was never detected. There was no statistically significant correlation between genotype and age, sex, source of infection, alanine aminotransferase pattern and histological activity index. These results indicate that genotype 1 b is widespread among Italian children with chronic hepatitis C, although with significant geographical variations. It is not associated with a more severe liver disease, therefore suggesting that the greater severity of liver disease recently reported in adults could reflect the cumulative effects of disease duration and of interfering cofactors.

High Viral Load and Mild Liver Injury in Children with Hemophilia Compared with Other Children with Chronic Hepatitis C Virus Infection

“…Although our cohort reflects patients referred to a tertiary center, most of the children were asymptomatic and had mild chronic hepatitis with low‐grade portal and lobular inflammation, generally without hepatic fibrosis or aggressive features. Similar mild asymptomatic liver disease in HCV‐infected children has been reported by European and Japanese investigators (13‐20) who attributed their findings to the short duration of HCV infection in children.…”

Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome

“…16 There is, instead, general agreement on the role of genotypes as predictors of response to IFN, alone or combined with ribavirin, the highest response rates being reported in patients infected with genotypes 2 and 3. 17 18 Little is known of HCV genotypes in children, [19][20][21] essentially because children are less commonly infected than adults. In Italy, the estimated prevalence of anti-HCV in the paediatric population was 0.3% in the early 1990s, 22 thus most paediatric studies were limited by the small sample size.…”