HEPATITIS-C VIRUS GENOTYPES IN CHRONIC HEPATITIS-C OF CHILDREN

Several hepatitis C virus (HCV) genotypes have been recently identifie d and genotype Ib has been correlated with severe liver disease and a poor response to interferon therapy, HCV infection in children is an i nteresting model for evaluation of the relationship between HCV genoty pes and liver disease, because of its relatively short duration and th e infrequent association with confounding cofactors, We have investiga ted HCV genotypes, using a dot-blot hybridization assay with genotype- specific probes, in 36 Italian children with chronic hepatitis C who w ere otherwise well and had no other underlying disease, Only four pati ents were symptomatic; liver histology, obtained in 33 patients, showe d minimal hepatitis in 17 and mild chronic hepatitis in 16, Infection with HCV genotype 1b was found in 55.5% of patients, with a peak preva lence of 83% in children from southern Italy (P < 0.05 vs other region s). The remaining children were infected with HCV genotype la (16.6%), genotype 2 (11.1%), and mixed (10.9%) or undetermined (2.7%) genotype s, In one patient, HCV viraemia was never detected, There was no stati stically significant correlation between genotype and age, sex, source of infection, alanine aminotransferase pattern and histological activ ity index. These results indicate that genotype Ib is widespread among Italian children with chronic hepatitis C, although with significant geographical variations. It is not associated with a more severe liver disease, therefore suggesting that the greater severity of liver dise ase recently reported in adults could reflect the cumulative effects o f disease duration and of interfering cofactors.