Study On The Relation Of Hepatitis C Virus Genotype With Clinical Characteristic In Chronic Hepatitis C Children

The study aim: to learn the relation of HCV genotype with clinical, biochemical, liver histological features in children with chronic hepatitis C(CHC). Patients: All 92 children (age2 ～ 18 years) who attended the fifth infection unit at the PLA of 302 hospital during the period of January 2004 ～ December 2006 were enrolled. Statistical analysis: Comparison of categorical variables was performed using the X~2 test or t test of Chiss and Excel (2003). Result: 1.Male were more than female in the children with chronic hepatitis C (3.18:1). The patients average age 12.21 ±0.78 years, and 89.1% were more than 7 years old , 3.2% were elder than 3. 71.7% of the patients infected by transfused blood products, which was higher than other type of exposure (P<0.01) . 2. Children with CHC were mostly free of symptoms. Children infected HCV genotype 1b were a few symptoms, and then all of the children infected HCV 2a were free. The level of ALT was beyond 200u/L in 4.1% of patients with HCV genotype 1b, and none was in 2a. However there was no difference between them who infected different HCV genotype so far as liver biochemical features. The percentage of them infected HCV genotype 1b who were CD4/CD8 lower than normality were 61.3%, then were higher than children infected HCV genotype 2a. 3. In 76.1% of the patients infected HCV genotype 1b and wers conspicuously more than the patients infected HCV genotype 1a, 1a/2b, unknown( P<0. 01). The gender composition, age and course of chronic HCV infection of the patients infected HCV genotype 1b was as same as them infected HCV others genotype. 4. In 41.3% of the patients the HCVRNA level was high, The average of HCVRNA was 4. 02×10~6±2.35×10~6copies/ml in the patients with genotype 1b, and 9. 1 ×10~6 ± 2. 37 ×10~6 copies/ml with 2a. There was no significant difference between them infected genotype 1b and 2a. 2 children (2.6%) had HBV co-infected. 5. 96. 8% washistological lesion and the grade of hepatitis activity was 1 or more than1 in all of them who underwent liver biopsy. 25.8% of them the grade of hepatitis activity was 2 or more than 2. All of children infected genotype 1b had histological lesion, and there were 4.1% the grade more than 2. The grade of hepatitis activity was not more than 2 in children who infected HCV genotype 2a. Liver biopsy specimen revealed cirrhosis in one of 31 children (3.2%).6. The level of HCVRNA and ALT was not predominance difference between the patients with different grade hepatitis activity. Conclusion: 1. Male were more than female in children chronic hepatitis C, mostly were school age. Blood transfusions represented the most frequent type of exposure. 2.Most of them symptom were delitescence. The patients with HCV genotype 1b had more symptom than genotype 2a. 3. Children's immunity function may be involved their clearing HCV capability and therapy effect.4. HCV genotype 1b was primal genotype. The level of HCVRNA in the children with CHC infected genotype 1b was not higher than the children infected HCV genotype 2a. Therefore the HCV genotype and the level of HCVRNA were independent in effecting antivirus therapy in the children with CHC. 5. All of children infected genotype 1b had histological lesion. It was not enough that the HCVRNA level and ALT level in blood was as the patient's condition guide in children CHC. Derive: To HCV genotype was important relation with clinic, biochemisty, liver histological lesion in children CHC. But it was not only, the relation with HCVRNA level, liver fibrosis index and the compliance of antivirus therapy else.