Introduction: Little is known on the clinical relevance of HCV genotypes in children with chronic hepatitis C, therefore we investigated epidemiological and clinical features in a large series of Italian children with different genotypes. Methods: The retrospective study was conducted as part of the Italian Observatory for pediatric HCV infection of the SIGEP hepatologic group and included 373 consecutive HCV RNA+, otherwise healthy children recruited in the outpatient clinic in 15 centers, since 1990. Genotypes were investigated by a commercial serologic assay (InnoLipa, Innogenetics). Results: The table synthesizes the features associated with the principal genotypes (10 cases had mixed or rare types). Genotypes 3 and 4 were largely associated with maternal transmission and thus infection with these types was usually recognized earlier in life. Ninety-six children were treated with IFN (sustained response = no viremia 6 months after stopping IFN). A statistically significant (p<0.01) difference in the rate of viremia clearance was found in children with genotypes 2 and 3 vs genotype 1. Overall 15 (6%) of untreated children lost HCV RNA (undetectable for at least 24 mo) during a mean follow-up period of 5.0+/-3.1 years. As reported in the table, 14 cleared viremia within the third year of life. At last visit, 37% of untreated children with genotype 2 had normal ALT and sustained viremia. Conclusion: Infection with genotype 3 is characterized by frequent perinatal onset, average higher ALT levels and a significantly greater propensity for spontaneous viremia clearance early in life; both types 2 and 3 are predictors of sustained response to IFN.
HCV genotypes and hepatitis C in children / Bortolotti F.;Resti M.;Verucchi G.; Marcellini M.; Nebbia G.; Giacchino R.;Marazzi M.; Zuin G.; Guido M.; Vajro P.; Barbera C.; Bartolcci S.;. - STAMPA. - 39 Supplement:(2004), pp. 120-121. (Intervento presentato al convegno 2nd world Congress of Pediatric Gastroenterology, Hepatology and Nutrition tenutosi a Paris nel 2-7 July 2004).
HCV genotypes and hepatitis C in children
VERUCCHI, GABRIELLA;
2004
Abstract
Introduction: Little is known on the clinical relevance of HCV genotypes in children with chronic hepatitis C, therefore we investigated epidemiological and clinical features in a large series of Italian children with different genotypes. Methods: The retrospective study was conducted as part of the Italian Observatory for pediatric HCV infection of the SIGEP hepatologic group and included 373 consecutive HCV RNA+, otherwise healthy children recruited in the outpatient clinic in 15 centers, since 1990. Genotypes were investigated by a commercial serologic assay (InnoLipa, Innogenetics). Results: The table synthesizes the features associated with the principal genotypes (10 cases had mixed or rare types). Genotypes 3 and 4 were largely associated with maternal transmission and thus infection with these types was usually recognized earlier in life. Ninety-six children were treated with IFN (sustained response = no viremia 6 months after stopping IFN). A statistically significant (p<0.01) difference in the rate of viremia clearance was found in children with genotypes 2 and 3 vs genotype 1. Overall 15 (6%) of untreated children lost HCV RNA (undetectable for at least 24 mo) during a mean follow-up period of 5.0+/-3.1 years. As reported in the table, 14 cleared viremia within the third year of life. At last visit, 37% of untreated children with genotype 2 had normal ALT and sustained viremia. Conclusion: Infection with genotype 3 is characterized by frequent perinatal onset, average higher ALT levels and a significantly greater propensity for spontaneous viremia clearance early in life; both types 2 and 3 are predictors of sustained response to IFN.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
