Symptomatic and Pathophysiologic Predictors of Hepatitis C Virus Progression in Pediatric Patients

Henderson, Wendy A.; Shankar, Ravi; Feld, Jordan J.; Hadigan, Colleen

doi:10.1097/inf.0b013e31819f1f71

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…This means that asymptomatic patients had lower levels. AST findings disagree to some extent with the results of Wendy et al, [16] who detected no correlation between severity of symptoms and AST levels. This could be related to the younger age of their patients and the possibility of short period of exposure.…”

Section: Discussioncontrasting

confidence: 89%

Can Fibrogenesis Markers Reflect Early Hepatic Histopathology in Chronic Hepatitis C?

El-Azm

Kobtan

El-Gendy

et al. 2014

Afro-Egyptian Journal of Infectious and Endemic Diseases

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Background and study aim: Chronic HCV can progress to cirrhosis, and HCC. Liver biopsy is the best to assess and monitor progression. But it has limitations.The aim of this study was to evaluate noninvasive indicators of fibrogenesis, matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-1 (T1MP1) and AST/Platelet (APRI-score) for assessment of early hepatic histopathology in chronic-HCV, and cirrhosis. Patients and methods: A cross section study included 344 participants from Tanta University Hospitals, (GI): 129 asymptomatic chronic-HCV, (GII): 135 with symptoms. (GIII): 80 patients with compensated HCV-related cirrhosis and 30 healthy controls. Investigations proved diagnosis, and excluded associated diseases. APRI-Score was evaluated. Quantitative immunoassay measured serum MMP-2 and TIMP-1, guided liver biopsy for histopathology staging and grading. Results: Serum MMP-2& TIMP-1 showed significant difference between control& GI, GII, GIII, and GI, GII& GIII (P< 0.001) with significant correlation between GI& GIII, between GII & GIII, while insignificant between G1 & GII. There was significant positive correlation between APRI-score versus Metavir A, Metavir F, Ishak score of fibrosis, serum MMP-2 and serum TIMP-1 (P <0.001). Combined serum MMP-2, TIMP-1 and APRI-score showed high sensitivity, and specificity. Conclusion: This combination of markers raised the sensitivity, specificity and correlations. It could reflect early hepatic histopathology, developing cirrhosis and potentially could replace liver biopsies in pre-treatment, follow up of chronic-HCV, and screening of asymptomatic patients.

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Section: Discussioncontrasting

confidence: 89%

Can Fibrogenesis Markers Reflect Early Hepatic Histopathology in Chronic Hepatitis C?

El-Azm

Kobtan

El-Gendy

et al. 2014

Afro-Egyptian Journal of Infectious and Endemic Diseases

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“…As so few patients with severe adverse outcome were reported, no correlation could be established between age at infection, mode of transmission or genotype and prognosis. Previous paediatric studies of referred patients have suggested that infection with genotype 1 or perinatal transmission may be risk factors for progression to cirrhosis , non‐white race may be a risk factor for fibrosis and male gender and low viral load may be risk factors for symptomatic disease . A recent commentary stated that the risk of progression is higher in children with the co‐occurrence of thalassaemia, iron overload, chemotherapy and HIV co‐infection .…”

Section: Discussionmentioning

confidence: 99%

The natural history of hepatitis C virus infection acquired during childhood

Robinson

Doucette

2011

Liver International

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Background The outcome of patients with hepatitis C virus (HCV) infection acquired during childhood in the absence of antiviral therapy is not clear. Aims The purpose of this study was to review the outcome of untreated HCV acquired in childhood. Only population‐based studies were included, as referred cases would be predicted to have more severe disease. Methods A systematic review of the literature was completed up to October 2010 to identify studies where a population was screened for HCV infection that was presumably acquired during childhood. Demographical and clinical data were collected on infected patients who had not been treated with an antiviral. Primary outcome was development of a severe adverse outcome (cirrhosis, hepatoma, need for a liver transplant or liver‐related death). Results There were 25 studies reporting a total of 733 infected patients. Liver biopsy results were provided for 180 patients (25%), revealing cirrhosis in eight (1.0% of the total and 4.0% of those who had a biopsy). None of the other patients developed a severe adverse outcome. As a result of the small number of patients with a severe adverse outcome, risk factors for HCV progression could not be identified. Conclusion Although HCV can lead to liver transplantation and death during childhood, the vast majority of patients with disease acquired during childhood have slowly progressive disease. There is no clear indication for antiviral therapy in the majority of children with HCV infection.

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“…The cirrhosis is present in 0 to 8% [26][27][28][29][30][31] and is rarely seen without underlying disorders [25]. The prevalence of steatosis is found in 10 to 27% [30,32,33].…”

Section: Histopathologymentioning

confidence: 99%

“…Hepatomegaly is noted in 10% of infants [6,9]. Only one study [32] showed that majority of cases of chronic liver disease were symptomatic. Provided the children are otherwise healthy and not affected by chronic illnesses, the characteristics of chronic HCV infection are not related to the mode of infection acquisition whether parenteral or vertical [6,49,50].…”

Section: Clinical Featuresmentioning

confidence: 99%

Hepatitis C in children: Clinical outcome, route of infection and diagnosis

Rehman

2010

J Pediatr Biochem

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Symptomatic and Pathophysiologic Predictors of Hepatitis C Virus Progression in Pediatric Patients

Abstract: BACKGROUND-The slow progression of HCV infection could ultimately negatively impact children during their lifespan. This study describes the symptomatic and pathophysiologic presentation of hepatitis C virus (HCV) infection in a cohort of pediatric outpatients.

Cited by 9 publications

References 21 publications

Can Fibrogenesis Markers Reflect Early Hepatic Histopathology in Chronic Hepatitis C?

Can Fibrogenesis Markers Reflect Early Hepatic Histopathology in Chronic Hepatitis C?

The natural history of hepatitis C virus infection acquired during childhood

Hepatitis C in children: Clinical outcome, route of infection and diagnosis

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