Serum levels of hepatitis C virus RNA in infants and children with chronichepatitis C

Background: The role of serum hepatitis C virus (HCV) load in infectivity, disease activity, and response to interferon treatment has been investigate d in adults, and controversial results have been obtained. Little is known about HCV load in infants and children with HCV infection. Purpose: To investigate the relation between HCV load in serum and features of associated liver disease in infants and children with HCV infection. Methods: Hepatitis C viral load was investigated in serial samples in 43 ch ildren with chronic HCV infection, including 32 patients aged 4 to 16 years infected by different routes and 11 vertically infected infants observed p rospectively since birth. Results: Overall viremia ranged between 2.7 and 6.9 log copies/ml (median, 5.56 log/ml) and fluctuated slightly during the follow-up. Median HCV RNA l evels did not significantly differ among infants, children, and adolescents . Viral load was also independent of sex, route of infection, clinical mani festation, alanine aminotransferase levels, and Liver histology, All 11 per inatally infected children became chronic HCV carriers, whatever their init ial viral load; retrospective testing of sera taken in the first day of lif e in three infants showed high viremia levels. Conclusions: Viremia levels observed in children were similar to those repo rted in adults, were independent of age, biochemical activity of liver dise ase, and chronicity of infection. They were also relatively stable, suggest ing that serial measurement of viral load is useless in untreated infants a nd children. The: detection of viremia at birth in children in whom chronic hepatitis developed later suggests the possibility of in utero infection.