Liver Steatosis in Children with Chronic Hepatitis C

Research has shown that liver fibrosis is associated with steatosis (fat accumulation in the liver) in adults with chronic hepatitis C, but there has been less research involving HCV-infected children.

As reported in the November 2006 American Journal of Gastroenterology, Italian researchers conducted a study to determine the prevalence and severity of steatosis in a pediatric population with chronic hepatitis C, and to evaluate its correlation with clinical parameters.

The investigators obtained liver biopsy results from 66 consecutive Italian and Spanish children with chronic hepatitis C (87.6% with genotype 1). Histological grade and stage were assessed according to the Ishak system. Steatosis was scored as absent, minimal (less than 5% of hepatocytes), mild (5%-33%), moderate (33%-66%), or severe (> 66%); moderate and severe scores were combined for statistical purposes. The body mass index (BMI) for age percentile (BMI%) was calculated at the time of liver biopsy. Cholesterol and triglyceride serum levels were available for 55 children.

Results

The prevalence of steatosis was 27% (18 out of 66 cases).

16 out of 18 children with HCV with genotype 1 had steatosis.

The rate was higher among Italian compared with Spanish children (10 out of 21 vs 7 out of 45; P = 0.01).

BMI% correlated significantly with both the presence of steatosis (P = 0.002) and its severity (P = 0.000).

Steatosis also correlated with serum triglyceride levels (P = 0.04).

Conclusion

"Steatosis is associated with BMI in children with chronic hepatitis C due mainly to genotype 1, and with no confounding hepatotoxic factors (alcohol or drugs)," the authors concluded. "This may reflect its metabolic rather than viral origin and raise new issues in the management of children with hepatitis C."

12/05/06

Reference
M Guido, F Bortolotti, P Jara, and others. Liver steatosis in children with chronic hepatitis C. Am J Gastroenterology 101(11): 2611-2615. November 2006.