Pathology of chronic hepatitis C in children

Abstract

Extensive studies on hepatitis C have been conducted since Limited information is available regarding the histology of the specific serological test for hepatitis C virus (HCV) infechepatitis C virus infection in children. The aim of this study tion was developed, and the characteristics of this disease was to determine the histological pattern of chronic hepatitis have been established. [1][2][3][4] Recent pathological studies have C (CHC) in children, and liver biopsy specimens from 109 clearly defined the histological characteristics of chronic heppediatric patients with CHC were examined. Each biopsy atitis C (CHC), e.g., lymphoid aggregates in the portal tract, specimen was evaluated based on a numerical scoring system bile duct damage, and large-droplet fatty changes, in comparfor the stage of fibrosis (1-4), the grade of portal/periportal ison to chronic hepatitis B (CHB). [5][6][7] However, in-depth studnecroinflammation (0-4), the grade of lobular necroinflammaies of CHC in children have not been conducted, and the tion (0-4), and their sum (final grade). The histological lesions histological characteristics of this disease in pediatric patients considered to be characteristic of chronic hepatitis were also remained to be identified, although it is well known that evaluated. None of the children had liver cirrhosis, and 105 even pediatric patients with CHB have various degrees of cases (97%) were stage 1 or 2. Only 4 children were stage 3.hepatic lesions ranging from mild fibrosis to liver cirrhosis. 8 Two of these 4 cases showed hemosiderosis. A significant Some studies have reported histopathology of CHC in pediatcorrelation was observed between the staging score and the ric patients, 9-13 but they examined only a small number of final grade in the pediatric patients (r Å .59; P õ .0001). The liver biopsy specimens, and their histological evaluation histological characteristics of adult CHC, such as lymphoid methods differed. For example, Inui et al. 9 examined the aggregate, bile duct injury, and fatty changes, were also obliver biopsy specimens of 25 pediatric patients with CHC served in the children. In conclusion, the majority of children who were all transfusion associated, but the investigators did with CHC presented with mild fibrosis, but a few showed not find liver cirrhosis. In contrast, Lai et al. 10 followed up CHC with lobular distortion and hemosiderosis. Frequent 46 thalassemic children who were treated with blood transfublood transfusion may aggravate hepatic lesions in pediatric sions and found that 5 patients (11%) developed liver cirrho-CHC. (HEPATOLOGY 1997;26:771-775.) sis during the following 8 years.The present study was designed to clarify the histological changes in the liver of pediatric patients with CHC. PATIENTS AND METHODSAbbreviations: HCV, hepatitis C virus; CHC, chronic hepatitis C; CHB, chronic hepatitis B.Patients. We collected 109 biopsy specimens from 109 pediatric men and 62 women who ranged in age from 23 to 95 years old Received September 27, 1996; accept...

Pathology of chronic hepatitis C in children: Liver biopsy findings in the Peds-C Trial

“…Thus, a total of 6 patients had already developed cirrhosis while still in childhood. Conversely, the prevalence of precirrhotic bridging fibrosis ranged from 4% in the larger Japanese series 4 to 44% in the earlier US series. 5 In the current series, only 4.2% had bridging fibrosis.…”

“…Cirrhosis was uncommon but was noted in several reports. There were no children with cirrhosis in either Japanese series 4,9 and only 1 in the Italian-Spanish series. 6,8 One of the previous US series 5 had 3 of 40 patients with cirrhosis.…”

“…The largest published series with sufficient detail [4][5][6][7][8][9][10] for comparison are listed in Table 7. There is some degree of overlap in the patients in several of these reports.…”

“…In the current series, we confirmed this by comparison with large cohorts of adults whose liver biopsy specimens were evaluated in similar treatment trials by the same pathologist. [16][17][18][19] Similarly, Kage et al 4 compared the biopsy specimens from children with a cohort of 120 adults and demonstrated that on average there was milder inflammation in children. A noteworthy finding in the current series was that 42% of children had minimal inflammation, in contrast to treatment-naïve adults in whom inflammation is minimal in only approximately 10%.…”

“…2,3 By contrast, relatively few children with chronic hepatitis C undergo liver biopsy, and there are only a few published series describing the range of histopathology in a significant number of patients. [4][5][6][7][8][9][10] In general, these have found that children tend to have milder disease than adults, with less inflammation, steatosis, and fibrosis, but with some variation between series collected in different parts of the world.…”