Symptomatic
Liver Disease Is Common among Children and Adolescents with Hepatitis C
 Wendy
Henderson from the National Institutes of Health analyzed the symptomatic and
pathophysiological presentation of HCV infection
in a cohort of pediatric outpatients. Because they are infected for so many years,
the slow progression of hepatitis C could ultimately have a negative impact on
pediatric patients during their lifespan, the authors noted as background.
The
researchers reviewed data from 62 HCV positive
children and adolescents aged 3 months to 19 years identified using diagnosis
codes from outpatient visits. Results  | 60%
of the pediatric patients presented with clinical symptoms of fatigue, joint pain,
abdominal pain, bruising or bleeding, or other non-specific symptoms. | | Liver
biopsies revealed that 35 patients (80%) had evidence of liver inflammation, 57%
had fibrosis, and 9% had steatosis
(fat accumulation). | | All
patients with steatosis or cirrhosis reported symptoms. | | Boys
were significantly more likely to be symptomatic compared with girls (58.3% vs
41.7%; P = 0.04). | | Patients
with symptoms were significantly older than those without (13.5 vs 8.9 years;
P = 0.003). | | There
was a significant inverse relationship between HCV viral load and symptoms (P
= 0.03). | | Pediatric
patients with low viral load (< 2 million copies/ml) were 5 times more likely
to have symptoms than those with high viral load (P = 0.03). | | There
were no significant relationships, however, between symptom status and race/ethnicity;
comorbidities; HCV genotype; ALT, AST or GGT liver enzyme levels; or extent of
histological liver damage. |
Based
on these findings, the study authors concluded, "Pediatric patients with
HCV can have significant symptoms and physiologic liver changes related to HCV." Biobehavioral
Unit, Symptoms Management Branch, Intramural Research Program, National Institute
of Nursing Research, National Institutes of Health, Bethesda, MD. 9/22/09 Reference
WA
Henderson, R Shankar, JJ Feld, and CM Hadigan. Symptomatic and pathophysiologic
predictors of hepatitis C virus progression in pediatric patients. Pediatric
Infectious Disease Journal 28(8): 724-727. August 2009. (Abstract).
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