6533b822fe1ef96bd127ce7a

RESEARCH PRODUCT

Chronic hepatitis C in children is a mild and curable liver disease

subject

description

Hepatitis C virus (HCV) infection is a major health problem orldwide, but children constitute only a small portion of infected atients. HCV transmission can occur through blood transfusion, nd the incidence of HCV infection was very high in children transused before 1990 for treatment of chronic haematological diseases 1] or other diseases that required blood transfusion [2]. Since he introduction of screening for HCV infection, blood transfusions ave become safe in developed countries, and the residual risk is oday very limited. In developed countries, maternal–fetal transmission has ecome themajor risk factor for HCV in children,with an estimated isk of infection ranging from 2% to 6% [3]. The key questions to anaging children with HCV chronic infection are identifying the vailable methods for the staging of the liver fibrosis in children ith chronic HCV infection, assessing the risk of developing cirhosis, and understanding the therapeutic options for curing HCV hronic hepatitis. Percutaneous liver biopsy is still the standardmethod for definng the grade of liver inflammation, and the stage of fibrosis. The se of liver biopsy in children is limited by the risk of complicaions, and by the reluctance, from both children and their parents, o consent to this procedure. However, in the last year, two studes have been published that included children with chronic HCV nfection who had undergone liver biopsy before starting antiviral reatment. Both reported a very low percentage of children with ignificant liver fibrosis. In the study by Sokal et al. [4], more than 5% of 65 children or adolescents included in a trial of treatment ith peginterferon alpha and ribavirin had no fibrosis, or had mild brosis; none of themhad severe fibrosis or cirrhosis. Anothermulicentre, controlled trial [5] reported that only 3 out of 104 children valuated for antiviral treatmenthadhistological evidenceof portal brosis with septa. Recently, non-invasive methods for assessing iver fibrosis, in place of biopsy, have been developed. Amongst hese methods, transient elastography has been applied and studed, mainly in adult patients with chronic HCV. There are few data n stiffness measurement of the liver by FibroScan in children. A tudy performed on 116 children, with amean age of 10 years, con-