Çocuklarda Kronik Hepatit C Enfeksiyonu (27 Vakanın Değerlendirilmesi)

Abstract

The risk of end stage liver disease and hepatocellular carcinoma is low in pediatric hepatitis C infection due to its slowly progressive course. But still, treatment is recommended in HCV infection in childhood period. 27 patients who have been diagnosed as chronic hepatitis C infection between 1995-2009 were included. Sixteen of the patients (59.3%) were males. We retrospectively reviewed demographic characteristics (patient age, sex, the city they have been living, complaints, comorbidities, route of infection), physical examination, laboratory findings befor the treatment, genotype, liver biopsies, treatment and related side effects. We compared the patients with and without sustained viral response in order to find the factors possibly affecting disease progression and the treatment response. HCV infection occured through parenteral route in 19 patients (70.4%), vertical route in 3 patients (11.1%) and surgery related contamination in 1 patient (3.7%), whereas none identified in 4 patients (14.8%). Eighteen patients (75%) were found to be genotype 1b, 4 patients (16.7%) as genotype 1a and 1 patient (4.2%) as genotype 1a+1b. A sustained viral response was achieved in 50%, 37.5% and 100% of the patients received IFN-α2a/2a, IFN-α2a/2b plus RBV and peg-IFNα, respectively. A relaps occured in 6 patients (23.1%). The mean scores of HAI and stage of fibrosis were 4.52 and 0.93, respectively. Cirrhosis was not occured in any of the patients. There was no statistically significant difference between the patients with and without sustained viral response by the meaning of age, sex, route of infection, comorbidities, physical examination findings, genotype, the number of the copies of HCV-RNA, pre-treatment liver biopsy and laboratory findings except the absence of hepatosteatosis in the patients with sustained viral response. In contrast, the rate of sustained viral response was higher in the patient with early and end of treatment viral response. In conclusion, chronic hepatitis C infection has a relatively mild course in children and a severe liver disease usually does not occur. Chronic hepatitis C infection requires treatment in children in order to avoid the complications although available treatment modalities still don’t provide sustained viral response in all of the patients.