Children With HCV Rarely Symptomatic Initially

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Children With HCV Rarely Symptomatic Initially

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NEW YORK (Reuters Health) Mar 21 - Children with hepatitis C virus

(HCV) infection, mostly acquired through blood transfusions, are

generally asymptomatic, according to a study of such patients treated

at a Washington, DC hospital.

In the February issue of the Journal of Pediatrics, Dr. Parvathi

Mohan of Childrens National Medical Center and colleagues note that

there is a lack of uniformity in the descriptions of the natural

history, clinical presentation, and histologic features of HCV

infection in children.

This prompted them to evaluate a cohort of 60 HCV-infected children

followed at the medical center over a 5-year period. Sources of

infection were transfusions (68%), perinatal transmission (13%), both

(7%), and unknown (12%). The mean age at infection was 7.1 months,

and the duration of infection was 13.4 years.

Mean alanine aminotransferase level was normal in 25% of the

children, up to 3-times normal in 62%, and greater than 3-times

normal in 13%. In addition, liver biopsy specimens showed minimal to

mild inflammation in 71%, absent or minimal fibrosis in 88%, and

bridging fibrosis in 12%.

Most patients were asymptomatic, but three patients had advanced

liver disease at presentation. Two died after transplantation.

Summing up, Dr. Mohan told Reuters Health that further research is

required, but " most children who acquire HCV infection early in life

manifest only mild liver disease over the first two decades of their

infection. "

" However, " she concluded, " it is apparent that severe liver disease

may develop in some -- and all children with HCV should be followed

closely. "

J Pediatr 2007;150:168-174.