Spontaneous remission of chronic hepatitis C in children


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The clinical course of 48 children with chronic hepatitis C (33 boys, 15 girls; mean age: 12.2 years) was monitored for more than 3 years to clarify its natural course. All patients were positive for the second-generation antibody to hepatitis C virus (anti-HCV) and for serum hepatitis C virus (HCV) RNA. All but one patient had a history of blood transfusion. Serum levels of alanine aminotransferase (ALT) had been abnormal for more than 1.5 years. Spontaneous remission defined as a biochemical remission lasting more than 1 year in association with the disappearance of serum HCV RNA, occurred in 4 (8.3%), however, in 25%, HCV RNA was still detectable in the liver even after its disappearance from serum. In this patient, the level of antibody to HCV core antigen (anti-HCV core) did not decrease significantly and serum HCV RNA eventually reappeared. The serum titre of HCV RNA in the 4 children with spontaneous remission was lower than in the remaining 44 children. Spontaneous remission may occur in children with chronic hepatitis C in whom the serum titre of HCV RNA is low and serum level of anti-HCV core decreases significantly. Assessment of the intrahepatic HCV RNA is necessary to confirm complete remission.

Conclusion A low serum titre of HCV RNA and a significant decrease in the serum titre of anti-HCV core were associated with spontaneous remission in children with chronic hepatitis C. Intrahepatic HCV RNA assessment is necessary to confirm complete remission.

AUTHOR: T. Fujisawa (1), H. Komatsu (1), A. Inui (1), Y. Miyagawa (1), M.Onoue (1), I. Sekine (1), S. Yokota (2), R. Hanada (3), K. Yamamoto (3), M.Inui (4), (1) Department of Paediatrics, National Defense Medical College,3-2, Namiki, Tokorozawa-City, Saitama 359, Japan, Tel.: 429-95-1511, Fax:429-96-5204;(2) Department of Paediatrics, Yokohama City University School of Medicine,Japan;(3) Department of Haematology and Oncology, Saitama Children's Medical Centre, Japan;(4) Department of Pathology, Koutoh Hospital, Japan
SOURCE: European Journal of Pediatrics , Volume 156 Issue 10 (1997) pp 773-776

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