role of hepatitis C virus in chronic hepatitis among children in Sharkia Governorate

ABSTRACT

To shed some light on the magnitude of HCV in causing chronic hepatitis and its relation to autoimmunity in children; this study was conducted on 45 children. They were divided into three groups. The first group included 15 children with chronic hepatitis who were exposed to repeated blood transfusion due to thalassemia [risky group]. The second group included 15 children with chronic hepatitis without exposure to repeated blood transfusion [non risky group]. The third group included 15 healthy children. All of the children are sex and age matched with ages ranging from 5 to 15 years [mean +/- SD 9.3 +/- 3.5] and they were of different residence and social standards in Sharkia Governorate, Egypt. All of the children were subjected to detailed history, full medical examination, liver function tests, abdominal sonography, direct Coomb's test, HbsAg, HCV 3[rd] generation ELISA and PCR in serum. Liver tissue PCR and pathology were studied in chronic hepatitis cases. Antinuclear antibody [ANA] and liver kidney microsomal antibody [LKM[1]] were done in HCV positive cases and in cases suspected to be autoimmune hepatitis. We have found that, 10 out of the 30 patients [33.3%] with chronic hepatitis had HCV infection. HCV positive cases were significantly higher in risky group [8/15] 53.3% than in non risky group [2/15] 13.3% [P<0.05], Twenty percent of HCV positive cases had ANA. However, these cases showed lower percentage of symptomatology and cirrhosis compared to autoimmune ANA positive hepatitis cases. In conclusion, HCV represents the most common cause of chronic hepatitis among children in Sharkia Governorate. HCV has the ability to produce ANA but this does not flare up the autoimmune disease. We recommend more meticulous mandatory blood screening for anti-HCV before transfusion. Also, we recommend routine regular screening for HCV infection in patients with repeated blood transfusion. Widely scaled studies are recommended to confirm our results: