Persistence Rate and Progression of Vertically Acquired Hepatitis C Infection

Abstract

Data were collected from 104 infected children who were followed up from birth for a mean of 49 (range, 6-153) months in 22 European centers, to outline the natural history of perinatal hepatitis C virus (HCV) infection. Fifty-four children were persistently HCV RNA positive, 44 were occasionally positive, and 6 never had detectable viremia. At least 90% of the children had evidence of ongoing infection at the latest analysis. Eighteen children became HCV RNA negative at their last assessments, but 40% of these had high alanine aminotransferase (ALT) concentrations. Infection was asymptomatic in all but 2 children, who developed hepatomegaly. Mean ALT concentrations decreased substantially after the first 2 years of life; 14 children had persistently normal ALT values. Signs of minimal to moderate inflammation were noted in all 20 patients who underwent liver biopsy. Perinatal HCV infection is usually asymptomatic in the first years of life, but the virus persists in most children, even in the absence of elevated ALT activity.

Genetic variation in the interleukin -28B gene is not associated with fibrosis progression in patients with chronic hepatitis C and known date of infection

“…For those patients, mean progression is 0.049 FPR units, corresponding approximately to an increase of 2 Ishak points in 40 years, similarly to other reports. 25,26 Additionally, male gender and HCV genotype 3 resulted in being significantly associated with fast progression, compared to female gender and HCV genotype 1, respectively. Although there is general agreement on the faster disease observed in males, the role of HCV genotype has remained controversial for a long time.…”

Evolution of hepatitis C viral quasispecies and hepatic injury in perinatally infected children followed prospectively

“…The criteria for the diagnosis of HCV infection have been reported in ref. 6. Physical examination and laboratory testing were usually done every 3-6 months during the first 2 years of life and then every 6 -12 months.…”

“…Age and mode of infection are assumed to influence the progression of HCV disease in adults, but limited data are available on the natural history of perinatally acquired HCV infection (4,5). Recent studies suggest that 80% of these children develop chronic infection (6)(7)(8), a rate similar to that documented in adults (9) but higher than that reported in children with posttransfusion HCV infection (10). Persistent HCV infection in infants and children is associated with minimal or mild liver damage and very rarely with advanced liver disease (5,(11)(12)(13)(14).…”

Longitudinal Long-term Follow-up Study of Children with Vertically Acquired Hepatitis C Virus Infection

“…These observations are consistent with those of Resti et al, 21 who concluded that high ALT levels during the first year of life are associated with a higher probability of HCV clearance, even though ALT levels are not a predictive factor for the patient's outcome. Data from the literature show that the viral clearance rate in children is about 15 -20%, with the remaining 80% staying chronically infected, 6,22,23 which is similar to adults. 5 Thus the age at acquisition of infection may not be a relevant factor for the persistence of HCV.…”