eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
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vol. 66
Original paper

Determinants of liver disease progression in children with chronic hepatitis C virus infection

Maria Pokorska-Śpiewak
Barbara Kowalik-Mikołajewska
Małgorzata Aniszewska
Magdalena Pluta
Bożena Walewska-Zielecka
Magdalena Marczyńska

Pol J Pathol 2015; 66 (4): 368-375
Online publish date: 2016/02/05
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Histopathological features and determinants of liver disease progression were analyzed in 42 treatment-naïve children (mean age: 10.7 ±3.7) with chronic hepatitis C (14/42 infected vertically and 26/42 horizontally). Histopathological evaluation was performed according to Knodell’s modified system. Predictors of necroinflammation and fibrosis were identified using linear regression analyses. Most children presented with mild necroinflammation and fibrosis (mean grade 4.3 ±2.7, mean staging 1.2 ±0.8), irrespective of the mode of transmission. Vertically infected children were younger than those infected horizontally (8.6 ±2.5 vs. 11.5 ±3.7 years, p = 0.02). Alanine and aspartate aminotransferase (ALT and AST) levels were associated with necroinflammation (p = 0.003 and p = 0.01 for ALT and AST, respectively) and fibrosis (p = 0.01 and p = 0.04, respectively). Other positive independent predictors of fibrosis included duration of infection (p = 0.03) and body mass index (BMI) z-score (p = 0.03).

Children with chronic hepatitis C presented with mild liver changes over a decade after the infection, irrespective of the mode of transmission. Since fibrosis is a time-dependent process, progression of the liver disease in vertically infected children may occur at a younger age compared to patients infected horizontally. Aminotransferase levels were associated with necroinflammation and fibrosis. Longer duration of infection and a higher BMI z-score were associated with more severe fibrosis.

chronic hepatitis, grading and staging, hepatitis C virus, liver biopsy, mother-to-child transmission

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