CHRONIC HEPATITIS IN CHILDREN AFTER LIVER-TRANSPLANTATION - ROLE OF HEPATITIS-C VIRUS AND HEPATITIS-G VIRUS-INFECTIONS

Background/Aims: Chronic graft hepatitis occurs in 20-30% adults after liver transplantation but the prevalence and causes in children are n ot known. in adults, hepatitis C virus infection is prevalent prior to transplantation and recurrent infection is a frequent cause of graft dysfunction. The significance of the recently described hepatitis G vi rus infection remains unproven, The aim of this study was to examine t he role of hepatitis C virus and hepatitis G virus infection inn chron ic graft hepatitis after paediatric liver transplantation, Methods: Th e prevalence of graft hepatitis and the role of hepatitis C virus and hepatitis G virus infections in 80 children after liver transplantatio n have been studied, with a median follow up of 4.4 years (range 0.4 t o 10.7), and the persistence of hepatitis G infection in the presence of immunosuppression has been determined. Results: Chronic graft hepat itis was diagnosed in 19/80 (24%) children and was most frequently see n in children transplanted for cryptogenic cirrhosis (71%). There was no significant difference in the prevalence of chronic hepatitis in th ose transplanted before or after donor anti-HCV screening. Hepatitis C infection occurred in three children transplanted prior to donor scre ening but in only one was associated with chronic hepatitis, Hepatitis G infection was found in 22/79 (28%) transplant recipients but was no t associated with graft hepatitis. In 17/21 children hepatitis G infec tion persisted for a median of 5.2 years after transplantation, Conclu sion: Chronic hepatitis occurred in 24% of children after liver transp lantation, a similar prevalence to that in adults, Cryptogenic liver d isease predisposed to graft hepatitis, but neither hepatitis C nor hep atitis G infection was associated. Hepatitis G virus caused a frequent and usually persistent infection after transplantation.