Histopathological features and determinants of
liver disease progression were analyzed in 42 treatment-naïve 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.