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Abstract
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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