Is HCV Infection Associated With Liver Steatosis In Children?

Research has shown that adult hepatitis C patients are likely to develop liver steatosis (accumulation of fat in liver cells), which is associated with more severe fibrosis. However, the incidence of steatosis in children with hepatitis C virus (HCV) infection has not been extensively studied.

Italian researchers analyzed the prevalence of steatosis in children with chronic hepatitis C and its relationship with clinical and laboratory features and response to interferon-based therapy. The retrospective study included 64 consecutive children undergoing liver biopsy.

Results

25% of the children showed evidence of mild to moderate steatosis.

Body mass index (BMI) did not significantly differ between children with and without steatosis.

No significant differences in necroinflammatory and fibrosis scores were observed between children with and without steatosis.

3 of the 16 children (18.7%) with steatosis had fibrosis scores greater than 2, compared with just 1 of the 48 children (2.1%) without steatosis (P < 0.05).

47 children, including 13 with steatosis, received treatment with interferon; sustained response was observed in 3 of the 13 children (23%) with steatosis and in 18 of the 34 children (53%) without steatosis.

Conclusion

"Histological evidence of steatosis is detectable in a fourth of children with chronic hepatitis C," the authors concluded. "Children with steatosis seem to have more severe fibrosis and lower rates of sustained response to interferon therapy" relative to children without steatosis."

Only one child in this study was infected with genotype 3 HCV. In adults, it has been shown that genotype 3 patients are more likely to develop steatosis compared to those with other genotypes. Based on the results of their study, the researchers suggested that, "Differently from adults, genotypes other than 3 may be associated with steatosis independently from classical metabolic risk factors."

8/21/06

Reference
A Giannattasio, M I Spagnuolo, A Sepe, and others. Is HCV infection associated with liver steatosis also in children? Journal of Hepatology 45(3): 350-354. September 2006.