Hepatitis C virus genotypes in chronic hepatitis C of
children
Several hepatitis C virus (HCV)
genotypes have been recently identified and genotype 1b has been
correlated with severe liver disease and a poor response to
interferon therapy. HCV infection in children is an interesting
model for evaluation of the relationship between HCV genotypes and
liver disease, because of its relatively short duration and the
infrequent association with confounding cofactors. We have
investigated HCV genotypes, using a dot-blot hybridization assay
with genotype-specific probes, in 36 Italian children with chronic
hepatitis C who were otherwise well and had no other underlying
disease. Only four patients were symptomatic; liver histology,
obtained in 33 patients, showed minimal hepatitis in 17 and mild
chronic hepatitis in 16. Infection with HCV genotype 1b was found
in 55.5% of patients, with a peak prevalence of 83% in children
from southern Italy (P < 0.05 vs other regions). The remaining
children were infected with HCV genotype 1a (16.6%), genotype 2
(11.1%), and mixed (10.9%) or undetermined (2.7%) genotypes. In one
patient, HCV viraemia was never detected. There was no
statistically significant correlation between genotype and age,
sex, source of infection, alanine aminotransferase pattern and
histological activity index. These results indicate that genotype 1
b is widespread among Italian children with chronic hepatitis C,
although with significant geographical variations. It is not
associated with a more severe liver disease, therefore suggesting
that the greater severity of liver disease recently reported in
adults could reflect the cumulative effects of disease duration and
of interfering cofactors.