VIRAL HEPATITIS

Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome

F Bortolotti¹, M Resti², M Marcellini³, R Giacchino⁴, G Verucchi⁵, G Nebbia⁶, L Zancan⁷, M G Marazzi⁸, C Barbera⁹, A Maccabruni¹⁰, G Zuin¹¹, G Maggiore¹², F Balli¹³, P Vajro¹⁴, L Lepore¹⁵, M Molesini¹⁶, M Guido¹⁷, S Bartolacci¹, F Noventa¹ the Italian Observatory for Hepatitis C in children

¹ Clinica Medica 5, University of Padua, Padua, Italy
² 3rd Paediatric Clinic, Meyer Hospital, Florence, Italy
³ Hepatologic Service, Hospital Bambin Gesù, Rome, Italy
⁴ Department of Infectious Diseases, Gaslini Institute, Genoa, Italy
⁵ Clinic of Infectious Diseases, Policlinico S Orsola, Bologna, Italy
⁶ Paediatric Clinic De Marchi, Milan, Italy
⁷ Department of Paediatrics, University of Padua, Padua, Italy
⁸ Department of Infectious Diseases, Gaslini Institute, Genoa, Italy
⁹ Paediatric Clinic, University of Turin, Turin, Italy
¹⁰ Department of Infectious Diseases, Policlinico S Mattia, Pavia, Italy
¹¹ Department of Paediatrics, Sacco Hospital, Milan, Italy
¹² Paediatric Clinic, University of Pisa, Pisa, Italy
¹³ Paediatric Clinic, University of Modena, Modena, Italy
¹⁴ Department of Paediatrics, University Federico II, Naples, Italy
¹⁵ Paediatric Clinic, University of Trieste, Trieste, Italy
¹⁶ Department of Paediatrics, B Roma Hospital, Verona, Italy
¹⁷ Department of Pathology, University of Padua, Padua, Italy

Correspondence to:
Correspondence to:
Dr F Bortolotti
Clinica Medica 5, Via Giustiniani 2, 35100 Padova Italy; flavia.bortolotti{at}unipd.it

Background and aim: Little is known of hepatitis C virus (HCV) genotypes in HCV infected children. This retrospective, multicentre study investigated genotype distribution and correlation with clinical features and outcome in a large series of Italian children.

Methods: Between 1990 and 2002, 373 HCV RNA positive children, consecutively recruited in 15 centres, were assayed for genotypes by a commercial line probe assay.

Results: The following genotype distribution pattern was recorded: genotype 1b = 41%; 1a = 20%; 2 = 17%; 3 = 14.5%; 4 = 5%; other = 2.5%. The prevalence of genotypes 1b and 2 decreased significantly (p<0.001) among children born from 1990 onwards compared with older children (46% v 70%) while the rate of genotypes 3 and 4 increased significantly (from 8% to 30%). Children infected with genotype 3 had the highest alanine aminotransferase levels and the highest rate of spontaneous viraemia clearance within the first three years of life (32% v 3% in children with genotype 1; p<0.001). Of 96 children enrolled in interferon trials during the survey, 22% definitely lost HCV RNA, including 57% of those with genotypes 2 and 3.

Conclusion: HCV genotypes 1 and 2 are still prevalent among infected adolescents and young adults in Italy but rates of infection with genotypes 3 and 4 are rapidly increasing among children. These changes could modify the clinical pattern of hepatitis C in forthcoming years as children infected with genotype 3 have the best chance of spontaneous viraemia clearance early in life, and respond to interferon in a high proportion of cases.

Abbreviations: HCV, hepatitis C virus; ALT, alanine aminotransferase; IFN, interferon; HAI, histological activity index; IVDA, intravenous drug abuse

Keywords: hepatitis C; hepatitis C virus genotypes; hepatitis C virus infection; children; interferon therapy

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Digest

Robin Spiller
Gut 2005 54: 735. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Guido, M., Bortolotti, F. (2008). Chronic viral hepatitis in children: any role for the pathologist?. Gut 57: 873-877 [Full Text]  
• Davison, S M, Mieli-Vergani, G, Sira, J, Kelly, D A (2006). Perinatal hepatitis C virus infection: diagnosis and management.. Arch. Dis. Child. 91: 781-785 [Abstract] [Full Text]  

eLetters:

Read all eLetters

Hepatitis C Virus Infection in Italy: A Dynamic Event

Silvia Sereno, et al.

Gut Online, 16 Aug 2005 [Full text]