Received 9 August
2002; accepted 20 October 2002; electronically published 14 January 2003.
The characteristics andevolution of hepatitis Cvirus (HCV) infection wereretrospectively investigated in
astudy of 224 HCVRNAseropositive
white children whowere consecutively recruited at7
European centers in19801998.
At presentation, allpatients were positive for
antibodies to hepatitis Cvirus, 87% were asymptomatic,and 48% had alanineaminotransferase (ALT) levels thatwere 2
times theupper limit of therange considered to benormal. Of 200 childrenfollowed for 117.5
years(mean follow-up ± standarddeviation [SD], 6.2 ±4.7 years), only 12(6%) achieved sustained viremiaclearance and normalization ofthe ALT level. In
92 revised liver biopsyspecimen analyses, the mean
fibrosis score (±SD) was1.5 ± 1.3 forchildren <15
years ofage and 2.3 ±1.2 for children
15
years of age (range,06
years; P <.01). Pediatric HCV infectionis
usually mild, butfew patients, especially thosewho
are perinatally infected,clear viremia in the
medium-term follow-up. Conversely, thehigher rates of fibrosisobserved in older patientssuggest the possibility ofan insidious progression ofHCV-associated liver disease.
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seropositive
white children who were consecutively recruited at 7
European centers in 1980
2
times the upper limit of the range considered to be
normal. Of 200 children followed for 1
15
years of age (range, 0