Chronic hepatitis C in children: The pathological and clinical spectrum

Background & Aims: Apart from the high-risk groups, the pathology of chroni c hepatitis C in children is not well known. The aim of this study was to i nvestigate the morphology of chronic hepatitis C in children without any un derlying systemic disease and to evaluate its relationship to clinicovirolo gical factors, Methods: Liver biopsy specimens from 80 children positive fo r antibody to hepatitis C virus were evaluated using a semiquantitative sco ring system. Results: Chronic hepatitis was mild in most cases but had high -grade activity in 17 children (21.2%), A significant association was found between the grade of focal necrosis and alanine transaminase levels (P < 0 .003), Fibrosis was absent in 22 cases (27.5%), mild in 44 (55%), and moder ate in 13 (16.2%). Only 1 patient had cirrhosis, A significant relationship was detected between fibrosis scores and (1) duration of disease (P < 0.03 ); (2) portal inflammation (P < 0.002); and (3) interface hepatitis (P < 0. 003), Conclusions: In otherwise healthy children, chronic hepatitis C is a morphologically mild disease in most cases. Fibrosis increases with the dur ation of disease, suggesting that end-stage disease may develop in young ad ulthood, Alanine transaminase levels correlate with intralobular focal necr osis but not with other lesions, In this respect, liver biopsy retains its importance in the management of chronic hepatitis C in children.