Chronic cryptogenic hepatitis in childhood is unrelated to hepatitis G virus

Objectives, The aim of this study was to define the features of chronic cry ptogenic hepatitis (CCH) in childhood and to investigate whether it is rela ted to hepatitis G virus infection. Methods, Forty-six children (24 males; age range, 1.5 to 17 years) with CCH were studied, CCH was diagnosed when serum alanine aminotransferase concen trations were more than 1.5 times normal for longer than 6 months without a ny apparent cause of liver disease. Results, No patient had acute symptomatic onset or had received a blood tra nsfusion, Three had undergone minor surgical procedures, All appeared to be healthy during follow-up (median, 4.2 years; range, 1 to 10 years). Hypert ransaminasemia was the only aberrant liver function test, Elevated serum al anine aminotransferase values alternated with normal values in 40 children (86.9%). Five children (10.8%) had a spontaneous sustained (>12 months) rem ission of hypertransaminasemia. Twelve (26%) had laboratory signs of autoim munity, but none fulfilled the criteria for autoimmune hepatitis. Of 20 chi ldren who underwent liver biopsy, 13 (65%) had minimal chronic hepatitis, 4 (20%) had mild chronic hepatitis and 3 (15%) had moderate chronic hepatiti s, Serum hepatitis G virus RNA was detected in 2 girls (4%) whose risk fact or was a hepatitis G virus-infected mother and a minor surgical procedure, respectively. In 12 families at least 1 other member had chronic liver dise ase, Conclusions. Childhood CCH seems to be a symptomless disease characterized by isolated hypertransaminasemia with onset during the first 4 years of lif e and mild to moderate histologic liver lesions. Although the frequency of spontaneous remissions is low, childhood CCH seems, in the short run, to be a nonprogressive disease. Hepatitis G virus does not play a major role in CCH.