6533b86cfe1ef96bd12c80a7
RESEARCH PRODUCT
Epidemiological profile of 806 Italian children with hepatitis C virus infection over a 15-year period
F BortolottiR IorioM RestiC CammàM MarcelliniR GiacchinoMg MarazziG VerucchiL ZancanC BarberaG MaggiorePietro VajroA GiannattasioS Bartolacci Italian Observatory For Hcv InfectionHepatitis C. In Childrensubject
MalePediatricsEpidemiologyInfectious Disease TransmissionCHILDRENHepacivirusmedicine.disease_causeGENOTYPES HCVRisk FactorsEpidemiologyPrevalenceVerticalChronicYoung adultChildHCV infection in childrenbiologyHepatitis C virus (HCV)Hepatitis CANTI-HCVHepatitis CItalyChild PreschoolHCVFemaleViral diseaseAdultmedicine.medical_specialtyEpidemiology of HCV infectionGenotypepediatricsHepatitis C virusSocio-culturaleEnzyme-Linked Immunosorbent AssayFlaviviridaeHCV vertical transmissionmedicineHumansBlood TransfusionSex DistributionPreschoolRetrospective StudiesEpidemiology of HCV infection; HCV infection in children; HCV vertical transmission; Hepatitis C virus (HCV); Adult; Blood Transfusion; Child; Child Preschool; Enzyme-Linked Immunosorbent Assay; Female; Genotype; Hepacivirus; Hepatitis C; Hepatitis C Antibodies; Hepatitis C Chronic; Humans; Infant; Infectious Disease Transmission Vertical; Italy; Male; Prevalence; Retrospective Studies; Risk Factors; Sex Distribution; HepatologyHepatologybusiness.industryHIVInfantRetrospective cohort studyHepatitis C AntibodiesHepatitis C Chronicmedicine.diseasebiology.organism_classificationHEPATITIS HCVInfectious Disease Transmission VerticalEl NiñoImmunologybusinessdescription
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 alpha. 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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2007-01-01 |