DETERMINANTS OF LIVER DISEASE PROGRESSION IN CHILDREN WITH CHRONIC HEPATITIS C VIRUS INFECTION

作者:Pokorska Spiewak Maria*; Kowalik Mikolajewska Barbara; Aniszewska Malgorzata; Pluta Magdalena; Walewska Zielecka Bozena; Marczynska Magdalena
来源:Polish Journal of Pathology, 2015, 66(4): 368-375.
DOI:10.5114/PJP.2015.57248

摘要

Histopathological features and determinants of liver disease progression were analyzed in 42 treatment-naive children (mean age: 10.7 +/- 3.7) with chronic hepatitis C (14/42 infected vertically and 26/42 horizontally). Histopathological evaluation was performed according to Knodell's modified system. Predictors of necroinflammation and fibrosis were identified using linear regression analyses. Most children presented with mild necroinflammation and fibrosis (mean grade 4.3 +/- 2.7, mean staging 1.2 +/- 0.8), irrespective of the mode of transmission. Vertically infected children were younger than those infected horizontally (8.6 +/- 2.5 vs. 11.5 +/- 3.7 years, p = 0.02). Alanine and aspartate aminotransferase (ALT and AST) levels were associated with necroinflammation (p = 0.003 and p = 0.01 for ALT and AST, respectively) and fibrosis (p = 0.01 and p = 0.04, respectively). Other positive independent predictors of fibrosis included duration of infection (p = 0.03) and body mass index (BMI) z-score (p = 0.03). Children with chronic hepatitis C presented with mild liver changes over a decade after the infection, irrespective of the mode of transmission. Since fibrosis is a time-dependent process, progression of the liver disease in vertically infected children may occur at a younger age compared to patients infected horizontally. Aminotransferase levels were associated with necroinflammation and fibrosis. Longer duration of infection and a higher BMI z-score were associated with more severe fibrosis.

  • 出版日期2015-12