Chronic hepatitis C in children: Clinical spectrum and histopathological study

Introduction: Hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. An estimated 180 million people are infected worldwide. The prevalence of hepatitis C virus (HCV) infection is relatively low in children, with an anti-HCV prevalence rate of 0.2–0.4% in the Western world. Egypt has the highest prevalence of adult HCV infection in the world, averaging 15–25% in rural communities. The main (90%) HCV genotype is type 4. The magnitude of HCV infection in children is not well studied. Asymptomatic HCV infection is detectable in 2.02% of Egyptian children. Aim: To study the clinical presentation and histopathological features of the liver in children with chronic hepatitis C infection. Methods: The study population included 40 children from 2 to 16 years who had been diagnosed with chronic hepatitis C (HCV-RNA positive for 6 months or more by Real-time PCR) in the liver clinic at El-Shatby Children Hospital. Results: Among the 40 patients’ biopsies, 26 (65%) were stage 0, 10 (25%) were stage 1, 4 (10%) were stage 2–3 (HAI). The grades of all 40 children ranged between 0 and 1 (HAI). Developing fibrosis was significantly associated with age (P =0.015). Conclusion: Children with chronicHCV infection are generally asymptomatic. Significant hepatic fibrosis was present in 10%of children with HCV infection. Fibrosis stage was significantly higher in older age children. There was no significant association between fibrosis stage and any biochemical parameter.