Clinical

Children with HCV rarely symptomatic initially

Last Updated: 2007-03-21 15:14:48 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - 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.