SUMMARY BackgroundNon-alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of liver injury. Currently, there are no proven effective therapies available. Atorvastatin is a new 3-hydroxy-3-metylglutaryl coenzyme A reductase inhibitor that reduces lipid serum levels.

SUMMARY BackgroundTransient elastography is a novel and non-invasive technique for the evaluation of fibrosis in chronic liver disease. Few studies that exist value the efficacy of transient elastography, mainly in hepatitis C virusinfected patients.

Limited information is available regarding the characteristics of the hepatitis C virus (HCV) infection in children.We compared the epidemiological background along with the virological and histological features as well as the intrahepatic immunologic phenotype of both children and adults with chronic hepatitis C (CHC). Serum samples of 24 pediatric and 32 adult patients were drawn for alanine transaminase (ALT) levels, HCV-typing, and viral load. The histological diagnosis and a semiquantitative immunohistochemical assessment were performed in all patients. The majority of children (62%) had been transfused and the mean duration of viral infection in these cases was 11 ؎ 4 years, being similar in adults (11 ؎ 9 years, not significant). Although genotype distribution was similar, viral load was lower in children than in adults. The mildest histological forms of chronic hepatitis along with a weak intrahepatic immunological phenotype were significantly more frequent among children than adult patients. In conclusion, in children with CHC, perinatal blood transfusion was the most frequent source of viral infection and the liver disease was characterized by both low ALT level and viral load, as well as the mildest histological and immunohistochemical forms of chronic hepatitis. (HEPATOLOGY 1998;28:1696-1701.)Hepatitis C virus (HCV) is a recognized causative agent of blood-borne non-A, non-B hepatitis 1 and chronic liver disease in both adults and children. 2-4 Currently, six major HCV types have been recognized 5 and these have a significant effect on the course of HCV-induced liver disease. 6,7 In adult patients, the natural history of chronic HCV infection is becoming better understood. It is estimated that 65% of those infected will develop some degree of chronic liver disease. 8,9 In addition, a number of immunohistochemical studies performed in adult patients with chronic hepatitis C (CHC) strongly support the assumption that T-cell-mediated immune reactions play an important role in the pathogenesis of liver damage, showing a high number of liver-infiltrating activated T cells along with an intrahepatic up-regulated expression of antigen recognition and intercellular and vascular adhesion molecules, which are essential for the cytolytic immune response. [10][11][12][13] By contrast, little is known concerning the clinical features and the histological outcome of CHC when the HCV infection is acquired early in life. Therefore, the aims of the present study were, first, to compare the epidemiological, clinical, virological, and histological features of both children and adult patients with CHC and, second, to characterize by immunohistochemistry the intrahepatic immunological phenotype of these patients. PATIENTS AND METHODS PatientsTwenty four Spanish children, who were referred to the Pediatric Hepatology Unit of the Hospital La Paz in Madrid, Spain because of persistently elevated serum alanine transaminase (ALT) levels, were included in this study. The diagnosis of CHC was further based on the presence of bo...