Hepatitis C infection in children: A Melbourne perspective

Karim, Bazlul; Alex, George; Smith, Arnold L.; Hardikar, Winita

doi:10.1046/j.1440-1754.2000.00524.x

Cited by 7 publications

(2 citation statements)

References 24 publications

(25 reference statements)

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“…In children, chronic HCV infection is mostly asymptomatic. Clinical manifestations are not prominent, except for a few mild constitutional symptoms and hepatomegaly80. The presence of chronic biochemical evidence of hepatitis, such as a high serum alanine aminotransferase (ALT) level, varies from 50 to 90% of children chronically infected with HCV 70 .…”

Section: Hepatitis Cmentioning

confidence: 99%

Molecular epidemiology of hepatitis B and C virus infections in Asia

Huy

Abe

2004

Pediatrics International

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The present paper provides a review of the current literature regarding the molecular-based epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV), which are very important viruses underlying the etiology of blood-borne infectious diseases worldwide. Particularly, both HBV and HCV are widespread on the Asian continent and are associated with acute and chronic liver diseases, including hepatocellular carcinoma. HBV has been classified into genotypes A through G and shown to have a distinct geographic distribution. In Asia, genotypes B and C of HBV prevail, and genotype C has been shown to cause more serious liver disease than genotype B. High prevalence of HBV mutants with various forms, such as the pre-S mutant, basal core promoter mutant, YMDD motif mutant and vaccine escape mutant, were seen in Asia and these were found to be related to the severity of liver disease and sensitivity to therapy. HCV has also been classified into multiple genotypes and associated with geographic distribution. HCV genotype 1 is less sensitive to interferon therapy and may be associated with the presence of more serious liver disease than the other genotypes. Data on the relation among the HBV/HCV genotypes, their pathogenicity in chronic liver diseases including hepatocellular carcinoma and their effect on therapy are awaited with great interest, especially in Asia, which is an endemic region of blood-borne hepatitis viruses.

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Section: Hepatitis Cmentioning

confidence: 99%

Molecular epidemiology of hepatitis B and C virus infections in Asia

Huy

Abe

2004

Pediatrics International

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“…In children, chronic hepatitis C is essentially asymptomatic, and there are few clinical signs apart from mild hepatomegaly in 11-48%. 15,16 Chronic biochemical evidence of hepatitis (raised serum alanine aminotransferase (ALT) level) has been demonstrated in several studies; it varies from 50 to 90% of children chronically infected with HCV. 16,17 Persistent viremia in those who are anti-HCV positive has also been described in 45-86% of cases.…”

Section: Clinical and Laboratory Features Of Hepatitis C In Childrenmentioning

confidence: 99%

Hepatitis C in childhood

Hardikar

2002

J of Gastro and Hepatol

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The approach of a pediatric hepatologist in managing children with hepatitis C virus (HCV) differs from adult practice, because the pediatric hepatologist is dealing with the beginning of a chronic illness in which long-term outcomes will not occur for 20 or 40 years, and it is not possible to predict in the early stages of the infection which patients have a more sinister prognosis. The prevalence of chronic HCV in children is low, but varies between different countries in the Asia-Pacific region. In most countries, screening of blood products for HCV has virtually eliminated the risk of post-transfusion HCV, so that in Australia children aged less than 11 years will not have acquired HCV from blood transfusion or extracorporeal membrane oxygenation. The risk of perinatal transmission of this virus is only about 6%, but this remains virtually the only source of HCV transmission for children in most countries. While available data are limited, mild histological changes are present in the majority of children with hepatitis C, and cirrhosis is rare. Unfortunately, long-term natural history studies of the course of HCV infection in children have not been reported. Individual decisions on antiviral treatment are more difficult in childhood, not because the treatment is any less effective or because of the severity of side-effects (which tend to be less severe than for adults), but because the long-term outcome of infection is unclear. At present, treatment should be confined to those with significant hepatic fibrosis and continued moderate to severe necroinflammatory change. Measures to prevent HCV infection in childhood center on whether, as recently suggested, elective cesarean section may reduce the risk of transmission. Despite the presence of HCV-RNA in some breast milk samples, there is no evidence that breast-feeding confers any risk of HCV infection.

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