Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome.

BACKGROUND AND AIMS: Little is known of hepatitis C virus (HCV) genotypes in HCV infected children. This retrospective, multicentre study investigated genotype distribution and correlation with clinical features and outcome in a large series of Italian children. METHODS: Between 1990 and 2002, 373 HCV RNA positive children, consecutively recruited in 15 centres, were assayed for genotypes by a commercial line probe assay. RESULTS: The following genotype distribution pattern was recorded: genotype 1b = 41%; 1a = 20%; 2 = 17%; 3 = 14.5%; 4 = 5%; other = 2.5%. The prevalence of genotypes 1b and 2 decreased significantly (p<0.001) among children born from 1990 onwards compared with older children (46% v 70%) while the rate of genotypes 3 and 4 increased significantly (from 8% to 30%). Children infected with genotype 3 had the highest alanine aminotransferase levels and the highest rate of spontaneous viraemia clearance within the first three years of life (32% v 3% in children with genotype 1; p<0.001). Of 96 children enrolled in interferon trials during the survey, 22% definitely lost HCV RNA, including 57% of those with genotypes 2 and 3. CONCLUSION: HCV genotypes 1 and 2 are still prevalent among infected adolescents and young adults in Italy but rates of infection with genotypes 3 and 4 are rapidly increasing among children. These changes could modify the clinical pattern of hepatitis C in forthcoming years as children infected with genotype 3 have the best chance of spontaneous viraemia clearance early in life, and respond to interferon in a high proportion of cases.

[Prevalence of HCV antibodies and vertical transmission of hepatitis C virus]. / Prevalenza dell'anti-HCV e trasmissione verticale del virus C.

HCV infection is one of the most frequent causes of hepatitis in man. There are numerous means of infection, not all of which can be documented. In infancy HCV infection occurs particularly in children that have been multitransfused or are on dialysis. Vertical transmission of HCV infection is rare, and the times and means of occurrence are not as yet well defined. The present study sets out to establish the prevalence of HCV-Ab carriers within a population of 4,242 pregnant women in Verona (Italy). It also aims to assess the incidence of vertical transmission of HCV infection in a sample of newborns examined over a 15-months follow-up. Of the 4,242 pregnant women subjected to screening, 45 (1.06%) were HCV-Ab positive. In only 74% of the cases it was possible to identify an HCV infection risk factor. On the 45 children of the HCV positive mothers, at present 25 have completed the 15 months follow-up. Only one of these children has contracted the infection: the incidence of transmission is therefore 4%.