In an analysis described in the March 2008
issue of Hepatology, investigators evaluated liver histopathology among
children with chronic hepatitis C participating in the Peds-C trial, which assessed
the safety and efficacy of pegylated
interferon alfa-2a (Pegasys) plus ribavirin in pediatric patients.
The
present analysis involved liver biopsies from 121 previously untreated children
ages 2 to 16 years (mean 9.8 years). Participants had no other identifiable causes
of liver disease besides HCV infection, no signs of hepatic decompensation, and
no other significant non-hepatic disease. Liver biopsies were scored for inflammation,
fibrosis, steatosis
(fat accumulation), and other histological features.
Results
•
Liver inflammation was minimal in 42% of the biopsy samples, mild in 17%, moderate
in 38%, and severe in 3%.
•
5 patients had bridging fibrosis and 2 had cirrhosis.
•
56% of samples showed no liver steatosis, 34% showed minimal steatosis, and 10%
showed mild steatosis; there were no cases of moderate or severe steatosis.
•
Inflammation scores correlated with fibrosis scores, serum alanine aminotransferase
(ALT) levels, and duration of HCV infection.
•
However, inflammation was not associated with patient age, body mass index (BMI),
or HCV genotype.
•
Fibrosis scores correlated with inflammation, but not with age, HCV genotype,
BMI, or steatosis.
•
Steatosis correlated with ALT levels and BMI, with overweight children having
more fibrosis than those who were not overweight.
Conclusion
In
conclusion, the authors wrote, "in this cohort of HCV-infected children,
inflammation, fibrosis, and steatosis were milder than reported for treatment-naive
adults with chronic hepatitis C, but there were several with bridging fibrosis
or cirrhosis."
They added that, "The positive correlation of
inflammation with duration of infection and fibrosis, and of obesity with fibrosis
suggest that children with chronic hepatitis C will be at risk for progressive
liver disease as they age and possibly acquire other comorbid risk factors."
3/14/08
Reference ZD
Goodman, HR Makhlouf, L Liu, and others. Pathology of chronic hepatitis C in children:
Liver biopsy findings in the Peds-C Trial. Hepatology 47(3): 836-843. March
2008.
While
the natural history of 
Results
