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Liver Histology and Alanine Aminotransferase Levels in Children
and Adults with Chronic Hepatitis C Infection
Chronic
hepatitis C is often a mild disease in children,
but whether this is related to younger age or shorter duration
of infection is unclear. Histologic severity
has been shown to correlate with duration of infection regardless
of age.
In
the current study, researchers compared histologic findings
in children and adults with chronic hepatitis C while controlling
for sex, duration of infection, hepatitis
C virus (HCV)-RNA level, and genotype.
Twenty-one
children and 52 adults whose infection was less than 20 years
in duration and who had undergone a liver
biopsy were included.
Two
blinded liver pathologists reviewed the liver biopsies and
scored inflammatory activity and fibrosis
using the modified Knodell scoring system.
Results
The groups were the same with
respect to HCV-RNA level (P = 0.8), and genotype (P = 0.6)
but differed in duration of disease (P = 0.01) and sex composition
(P = 0.005).
Covariate
analysis showed no influence of genotype, duration of infection,
or HCV-RNA level on outcome.
In
controlling for sex, children had significantly milder liver
disease and alanine aminotransferase
(ALT) elevations.
In
conclusion, the study authors write, “With equal duration
of infection, HCV-RNA level, and genotype, children have lower
serum ALT levels and less severe liver disease than adults
infected with HCV.”
Hepatobiliary Program, Division of Gastroenterology and
Nutrition, Department of Pediatrics, Children's Hospital and
Regional Medical Center, Seattle, Washington; Department of
Pathology, University of Washington Medical Center and Children's
Hospital and Regional Medical Center, Seattle, Washington;
GI Pathology Partners, P.C., Memphis, Tennessee; Pediatric
Clinical Research Center, Children's Hospital and Regional
Medical Center, Seattle, Washington; Hepatology Section, Division
of Gastroenterology, Department of Medicine, University of
Washington Medical Center, Seattle, Washington.
11/02/05
Reference
K
F Murray and others. Liver Histology and Alanine Aminotransferase
Levels in Children and Adults with Chronic Hepatitis C Infection.
Journal of Pediatric
Gastroenterology and Nutrition
41(5):634-638. November 2005.
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