PEDIATRICS Vol. 94 No. 6 December 1994, pp. 919-922
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Serologic, Virologic, and Histologic Characteristics of Chronic Phase Hepatitis C Virus Disease in Children Infected by Transfusion

Suguru Matsuoka MD1, Katsuyoshi Tatara MD1, Yasunobu Hayabuchi MD1, Yoshiyuki Taguchi MD1, Kazuhiro Mori MD1, Yasuhiro Kuroda MD1, Hirohito Honda MD2, Susumu Itou MD2, and Yasuto Yuasa MD3

1 Department of Pediatrics University of Tokushima, School of Medicine, Tokushima, Japan
2 Second Department of Internal Medicine, University of Tokushima, School of Medicine, Tokushima, Japan
3 Tokusima Prefectural Central Hospital, Tokushima, Japan

Objective. We studied the time course of hepatic dysfunction, seropositivity to hepatitis C virus (HCV) antibodies, viremia, and histologic evidence of hepatic injury to evaluate the course of HCV infection in children infected by blood transfusion.

Patients and methods. Twenty-nine patients (ages 4 to 18 years) who underwent open-heart surgeries for congenital heart disease were grouped into three categories based on alterations in serum alanine aminotransferase (ALT) levels: Group A, acute infection; Group B, subacute infection; and Group C, chronic infection.

Results. In Group C, all 13 patients had detectable HCV RNA in serum. In contrast, all patients in Group A had no detectable HCV RNA. In Group B, one of nine patients had detectable HCV RNA and two of four patients examined had persistent chronic hepatitis by histologic criteria. Antibodies directed against C100-3 antigen or core-antigen were more useful than second-generation HCV antibody assays in determining the relationship between viremia and immunologic response. Infection with HCV genotype II and the presence of higher HCV RNA copy numbers were associated with histologic evidence of hepatic damage.

Conclusion. An abnormal ALT value is frequently associated with viremia, and biochemically resolved acute infection reflects clearance of HCV. However, a normal ALT does not always reflect an absence of hepatocyte damage and HCV replication in patients with subacute disease. The measures outlined in this study are useful indicators of disease activity during the chronic phase of post-transfusion HCV infection.

Submitted on February 16, 1994
Accepted on May 13, 1994




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