Pathology of Chronic Hepatitis C in Children: Peds-C Trial
While the natural history of chronic hepatitis C virus (HCV) infection has been well studied in adults, less is known about how the disease progresses in children.
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.
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."
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.