Reuters Health Information (2005-06-28): Three modalities seen in vertically acquired HCV
Three modalities seen in vertically acquired HCV
Last Updated: 2005-06-28 15:59:47 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Between 20% and 25% of
children vertically infected with hepatitis C may clear the virus, most
by 3 years of age, according to a new study from the European
Paediatric Hepatitis C Virus Network.
There also appear to be three categories of infection in these
children, similarly to adults, Dr. Marie-Louise Newell of the Institute
of Child Health at University College, London and colleagues conclude:
those who clear the virus, 50% with chronic, asymptomatic infection,
and 30% with chronic, active infection.
The researchers followed 266 children who acquired the virus
vertically, from birth up to a median of 4.2 years of age. Children
were considered infected based on two or more PCR tests positive for
HCV RNA, or a positive test for HCV antibody at 18 months of age or
older. Ten percent of the children also were infected with HIV.
One in ten children of the children had hepatomegaly, the only
clinical sign of disease seen in the group, the researchers report in
the July 1st issue of Clinical Infectious Diseases. Children with
abnormally high alanine transaminase (ALT) levels were four times more
likely to have hepatomegaly.
The children who had a lower percentage of positive PCR tests were
more likely to clear the virus, as were those with a lower percentage
of abnormal ALT tests.
The researchers note that their estimated clearance rate is
conservative, given that it does not include children who were
PCR-negative but antibody positive after 18 months of age.
"Given the long latency time between infection and symptoms of 20
years or greater in adults, the lack of serious clinical manifestations
among the children in our study highlights the need to investigate
approaches to monitor the long-term consequences of vertically acquired
HCV infection," the researchers conclude.
Clin Infect Dis 2005;41:45-51.