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Clinical spectrum and histopathologic features of chronic hepatitis C infection in children

Parvathi Mohan1, Camilla Colvin, Chevelle Glymph

  • 1Department of Gastroenterology and Nutrition, Children's National Medical Center, Washington, DC 20010, USA. pmohan@cnmc.org

The Journal of Pediatrics
|January 24, 2007
PubMed

Insights

Children with hepatitis C virus (HCV) infection acquired at birth or in early childhood are often asymptomatic. However, by 13 years post-infection, 12% developed significant liver fibrosis, highlighting the chronic nature of pediatric HCV.

Area of Science:

  • Pediatric Hepatology
  • Viral Hepatitis Research
  • Infectious Diseases in Children

Background:

  • Hepatitis C virus (HCV) infection in children acquired perinatally or through early transfusion poses long-term health risks.
  • Understanding the natural history of pediatric HCV is crucial for effective management and prognosis.
  • Limited data exists on the long-term outcomes of childhood HCV infection.

Purpose of the Study:

  • To define the natural history and clinical outcomes of children infected with hepatitis C virus (HCV) at birth or in early childhood.
  • To correlate clinical findings and laboratory results with liver biopsy data in pediatric HCV patients.

Main Methods:

  • Retrospective and prospective study of 60 children with HCV infection.
  • Identification of cases through transfusion look-back programs and patient referrals.
  • Correlation of perinatal/transfusion history, clinical course, and lab studies with 42 liver biopsy findings.

Main Results:

  • Mean age at infection was 7.1 months, with a mean infection duration of 13.4 years; common sources were blood transfusion (68%) and perinatal transmission (13%).
  • Most children were asymptomatic, but referral patients showed advanced liver disease; 12% had bridging fibrosis by 13 years post-infection.
  • Liver biopsies revealed minimal inflammation and absent/minimal fibrosis in most, but age at infection and specific lab markers correlated with fibrosis progression.

Conclusions:

  • Children with chronic HCV infection are typically asymptomatic, but significant fibrosis can develop over time.
  • Referral-based cohorts may overestimate disease severity due to selection bias.
  • Early identification and monitoring are essential for managing long-term outcomes in pediatric HCV.
Abstract

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