Pathology of chronic hepatitis C in children

Liver biopsy findings in the Peds-C trial

Zachary D. Goodman, Hala R. Makhlouf, Lea Liu, William Balistreri, Regino P. Gonzalez-Peralta, Barbara Haber, Maureen M. Jonas, Parvathi Mohan, Jean Molleston, Karen F. Murray, Michael R. Narkewicz, Philip Rosenthal, Lesley J. Smith, Patricia R. Robuck, Kathleen B. Schwarz

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

There is relatively little information in the literature on the histopathology of chronic hepatitis C in children. The Peds-C Trial, designed to test the efficacy and safety of peginterferon alfa-2a and ribavirin in children, provided an opportunity to examine liver biopsies from 121 treatment-naive children, ages 2 to 16 (mean, 9.8 years) infected with the hepatitis C virus (HCV) and with no other identifiable cause for liver disease, signs of hepatic decompensation, or another significant nonhepatic disease. Liver biopsies were scored for inflammation, fibrosis, steatosis, and other histological features. Inflammation in the biopsy was minimal in 42%, mild in 17%, moderate in 38%, and severe in only 3%. Five had bridging fibrosis, and 2 had cirrhosis. Steatosis was absent in 56%, minimal in 34%, and mild in 10%. Inflammation scores correlated with fibrosis scores, serum alanine aminotransferase levels, and duration of infection, but not with age, body mass index z score, or HCV genotype. Fibrosis scores correlated with inflammation but not with age, HCV genotype, body mass index z score, or steatosis parameters. Steatosis correlated with serum alanine aminotransferase levels and body mass index z scores; overweight children had more fibrosis than the non-overweight. In conclusion, in this cohort of HCV-infected children, inflammation, fibrosis, and steatosis were milder than reported for treatment-naive adults with chronic hepatitis C, but there were several with bridging fibrosis or cirrhosis. The positive correlation of inflammation with duration of infection and fibrosis and of obesity with fibrosis suggest that children with chronic hepatitis C will be at risk for progressive liver disease as they age and possibly acquire other comorbid risk factors.

Original languageEnglish (US)
Pages (from-to)836-843
Number of pages8
JournalHepatology
Volume47
Issue number3
DOIs
StatePublished - Mar 2008
Externally publishedYes

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Chronic Hepatitis C
Fibrosis
Pathology
Biopsy
Liver
Inflammation
Hepacivirus
Body Mass Index
Alanine Transaminase
Liver Diseases
Genotype
Ribavirin
Infection
Serum
Obesity
Safety

ASJC Scopus subject areas

  • Hepatology
  • Medicine(all)

Cite this

Goodman, Z. D., Makhlouf, H. R., Liu, L., Balistreri, W., Gonzalez-Peralta, R. P., Haber, B., ... Schwarz, K. B. (2008). Pathology of chronic hepatitis C in children: Liver biopsy findings in the Peds-C trial. Hepatology, 47(3), 836-843. https://doi.org/10.1002/hep.22094

Pathology of chronic hepatitis C in children : Liver biopsy findings in the Peds-C trial. / Goodman, Zachary D.; Makhlouf, Hala R.; Liu, Lea; Balistreri, William; Gonzalez-Peralta, Regino P.; Haber, Barbara; Jonas, Maureen M.; Mohan, Parvathi; Molleston, Jean; Murray, Karen F.; Narkewicz, Michael R.; Rosenthal, Philip; Smith, Lesley J.; Robuck, Patricia R.; Schwarz, Kathleen B.

In: Hepatology, Vol. 47, No. 3, 03.2008, p. 836-843.

Research output: Contribution to journalArticle

Goodman, ZD, Makhlouf, HR, Liu, L, Balistreri, W, Gonzalez-Peralta, RP, Haber, B, Jonas, MM, Mohan, P, Molleston, J, Murray, KF, Narkewicz, MR, Rosenthal, P, Smith, LJ, Robuck, PR & Schwarz, KB 2008, 'Pathology of chronic hepatitis C in children: Liver biopsy findings in the Peds-C trial', Hepatology, vol. 47, no. 3, pp. 836-843. https://doi.org/10.1002/hep.22094
Goodman ZD, Makhlouf HR, Liu L, Balistreri W, Gonzalez-Peralta RP, Haber B et al. Pathology of chronic hepatitis C in children: Liver biopsy findings in the Peds-C trial. Hepatology. 2008 Mar;47(3):836-843. https://doi.org/10.1002/hep.22094
Goodman, Zachary D. ; Makhlouf, Hala R. ; Liu, Lea ; Balistreri, William ; Gonzalez-Peralta, Regino P. ; Haber, Barbara ; Jonas, Maureen M. ; Mohan, Parvathi ; Molleston, Jean ; Murray, Karen F. ; Narkewicz, Michael R. ; Rosenthal, Philip ; Smith, Lesley J. ; Robuck, Patricia R. ; Schwarz, Kathleen B. / Pathology of chronic hepatitis C in children : Liver biopsy findings in the Peds-C trial. In: Hepatology. 2008 ; Vol. 47, No. 3. pp. 836-843.
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abstract = "There is relatively little information in the literature on the histopathology of chronic hepatitis C in children. The Peds-C Trial, designed to test the efficacy and safety of peginterferon alfa-2a and ribavirin in children, provided an opportunity to examine liver biopsies from 121 treatment-naive children, ages 2 to 16 (mean, 9.8 years) infected with the hepatitis C virus (HCV) and with no other identifiable cause for liver disease, signs of hepatic decompensation, or another significant nonhepatic disease. Liver biopsies were scored for inflammation, fibrosis, steatosis, and other histological features. Inflammation in the biopsy was minimal in 42{\%}, mild in 17{\%}, moderate in 38{\%}, and severe in only 3{\%}. Five had bridging fibrosis, and 2 had cirrhosis. Steatosis was absent in 56{\%}, minimal in 34{\%}, and mild in 10{\%}. Inflammation scores correlated with fibrosis scores, serum alanine aminotransferase levels, and duration of infection, but not with age, body mass index z score, or HCV genotype. Fibrosis scores correlated with inflammation but not with age, HCV genotype, body mass index z score, or steatosis parameters. Steatosis correlated with serum alanine aminotransferase levels and body mass index z scores; overweight children had more fibrosis than the non-overweight. In conclusion, in this cohort of HCV-infected children, inflammation, fibrosis, and steatosis were milder than reported for treatment-naive adults with chronic hepatitis C, but there were several with bridging fibrosis or cirrhosis. The positive correlation of inflammation with duration of infection and fibrosis and of obesity with fibrosis suggest that children with chronic hepatitis C will be at risk for progressive liver disease as they age and possibly acquire other comorbid risk factors.",
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AU - Gonzalez-Peralta, Regino P.

AU - Haber, Barbara

AU - Jonas, Maureen M.

AU - Mohan, Parvathi

AU - Molleston, Jean

AU - Murray, Karen F.

AU - Narkewicz, Michael R.

AU - Rosenthal, Philip

AU - Smith, Lesley J.

AU - Robuck, Patricia R.

AU - Schwarz, Kathleen B.

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