Back to Search
Start Over
Long-term course of chronic hepatitis C in children: from viral clearance to end-stage liver disease
- Source :
- Gastroenterology. 134(7)
- Publication Year :
- 2007
-
Abstract
- Background & Aims: The natural course of chronic hepatitis C (CHC) in children is not well understood. The aim of this study was to assess the long-term course of CHC in a large sample of otherwise healthy children. Methods: From 1990 to 2005, 504 consecutive antihepatitis C virus (HCV)-positive children were enrolled at 12 centers of a national observatory and were followed up retrospectively/prospectively. Results: Putative exposure was perinatal in 283 (56.2%) cases, parenteral in 158 (31.3%), and unknown in 63 (12.5%). At baseline, 477 (94.6%) cases were HCV RNA seropositive, 118 (24.7%) of which were treated with standard interferon α. Ten years after putative exposure, the outcome in 359 HCV RNA-positive, untreated patients was (1) undetectable viremia in 27 (7.5%) (by Cox regression analysis, spontaneous viral clearance was independently predicted by genotype 3 [hazard ratio 6.44; 95% confidence interval: 2.7–15.5]) and (2) persistent viremia in 332 (92%) cases. Six of these 332 cases (1.8%) progressed to decompensated cirrhosis (mean age, 9.6 years). This latter group included 5 Italian children perinatally infected with genotype 1a (4 of the mothers were drug users). Thirty-three (27.9%) treated patients achieved a sustained virologic response. Conclusions: Over the course of a decade, few children with chronic HCV infection cleared viremia spontaneously, and those who did were more likely to have genotype 3. Persistent viral replication led to end-stage liver disease in a small subgroup characterized by perinatal exposure, maternal drug use, and infection with HCV genotype 1a. Children with such features should be considered for early treatment.
- Subjects :
- Liver Cirrhosis
Male
Time Factors
Hepacivirus
Chronic hepatitis C
Gastroenterology
Liver disease
Viral
Prospective Studies
Chronic
Prospective cohort study
Child
Children
chronic epatitis C
long term course
children
biology
Hazard ratio
Hepatitis C
Viral Load
Treatment Outcome
Italy
Child, Preschool
HCV
Disease Progression
RNA, Viral
Female
Viral load
medicine.medical_specialty
Adolescent
Genotype
Alpha interferon
Socio-culturale
Viremia
Antiviral Agents
Risk Assessment
HEPATITIS
Internal medicine
medicine
Humans
Hepatitis C, Chronic
Infant
Interferon-alpha
Proportional Hazards Models
Retrospective Studies
Preschool
Hepatology
business.industry
Long-term course
biology.organism_classification
medicine.disease
Immunology
RNA
business
Subjects
Details
- ISSN :
- 15280012
- Volume :
- 134
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Gastroenterology
- Accession number :
- edsair.doi.dedup.....9949249c19e542537f1fde5fa5c1db92