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Hepatitis C virus genotypes in chronic hepatitis C of children
F Bortolotti1, P Vajro, F Balli
1Clinica Medica 2, Padua, Italy.
Insights
Hepatitis C virus (HCV) genotype 1b is common in Italian children with chronic hepatitis C, particularly in the south. This genotype did not correlate with more severe liver disease in this pediatric cohort.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Hepatitis C virus (HCV) genotype 1b is linked to severe liver disease and poor interferon response in adults.
- HCV infection in children offers a unique model to study genotype-disease relationships due to shorter duration and fewer cofactors.
Purpose of the Study:
- To investigate the prevalence of different HCV genotypes in Italian children with chronic hepatitis C.
- To evaluate the association between HCV genotypes and liver disease severity in pediatric patients.
Main Methods:
- A dot-blot hybridization assay with genotype-specific probes was used to determine HCV genotypes.
- Study included 36 Italian children with chronic hepatitis C, assessing clinical and histological data.
Main Results:
- HCV genotype 1b was prevalent in 55.5% of children, with higher rates (83%) in southern Italy.
- Other genotypes identified included 1a (16.6%), 2 (11.1%), and mixed/undetermined types.
- No significant correlation was found between HCV genotype and age, sex, infection source, ALT levels, or histological activity.
Conclusions:
- HCV genotype 1b is widespread in Italian children with chronic hepatitis C, showing geographical variation.
- In children, genotype 1b is not associated with more severe liver disease, unlike observations in adults.
- The increased severity in adults may be due to longer disease duration and confounding factors.
Abstract:
Several hepatitis C virus (HCV) genotypes have been recently identified and genotype 1b has been correlated with severe liver disease and a poor response to interferon therapy. HCV infection in children is an interesting model for evaluation of the relationship between HCV genotypes and liver disease, because of its relatively short duration and the infrequent association with confounding cofactors. We have investigated HCV genotypes, using a dot-blot hybridization assay with genotype-specific probes, in 36 Italian children with chronic hepatitis C who were otherwise well and had no other underlying disease. Only four patients were symptomatic; liver histology, obtained in 33 patients, showed minimal hepatitis in 17 and mild chronic hepatitis in 16. Infection with HCV genotype 1b was found in 55.5% of patients, with a peak prevalence of 83% in children from southern Italy (P < 0.05 vs other regions). The remaining children were infected with HCV genotype 1a (16.6%), genotype 2 (11.1%), and mixed (10.9%) or undetermined (2.7%) genotypes. In one patient, HCV viraemia was never detected. There was no statistically significant correlation between genotype and age, sex, source of infection, alanine aminotransferase pattern and histological activity index. These results indicate that genotype 1 b is widespread among Italian children with chronic hepatitis C, although with significant geographical variations. It is not associated with a more severe liver disease, therefore suggesting that the greater severity of liver disease recently reported in adults could reflect the cumulative effects of disease duration and of interfering cofactors.