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Gut 2005;54:852-857 doi:10.1136/gut.2004.053744
  • Viral hepatitis

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

  1. F Bortolotti1,
  2. M Resti2,
  3. M Marcellini3,
  4. R Giacchino4,
  5. G Verucchi5,
  6. G Nebbia6,
  7. L Zancan7,
  8. M G Marazzi8,
  9. C Barbera9,
  10. A Maccabruni10,
  11. G Zuin11,
  12. G Maggiore12,
  13. F Balli13,
  14. P Vajro14,
  15. L Lepore15,
  16. M Molesini16,
  17. M Guido17,
  18. S Bartolacci1,
  19. F Noventa1,
  20. the Italian Observatory for Hepatitis C in children
  1. 1Clinica Medica 5, University of Padua, Padua, Italy
  2. 23rd Paediatric Clinic, Meyer Hospital, Florence, Italy
  3. 3Hepatologic Service, Hospital Bambin Gesù, Rome, Italy
  4. 4Department of Infectious Diseases, Gaslini Institute, Genoa, Italy
  5. 5Clinic of Infectious Diseases, Policlinico S Orsola, Bologna, Italy
  6. 6Paediatric Clinic De Marchi, Milan, Italy
  7. 7Department of Paediatrics, University of Padua, Padua, Italy
  8. 8Department of Infectious Diseases, Gaslini Institute, Genoa, Italy
  9. 9Paediatric Clinic, University of Turin, Turin, Italy
  10. 10Department of Infectious Diseases, Policlinico S Mattia, Pavia, Italy
  11. 11Department of Paediatrics, Sacco Hospital, Milan, Italy
  12. 12Paediatric Clinic, University of Pisa, Pisa, Italy
  13. 13Paediatric Clinic, University of Modena, Modena, Italy
  14. 14Department of Paediatrics, University Federico II, Naples, Italy
  15. 15Paediatric Clinic, University of Trieste, Trieste, Italy
  16. 16Department of Paediatrics, B Roma Hospital, Verona, Italy
  17. 17Department of Pathology, University of Padua, Padua, Italy
  1. Correspondence to:
    Dr F Bortolotti
    Clinica Medica 5, Via Giustiniani 2, 35100 Padova Italy; flavia.bortolotti{at}unipd.it
  • Accepted 22 December 2004
  • Revised 21 December 2004

Abstract

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.

Footnotes

  • Conflict of interest: None declared.

This Article

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