Spontaneous remission of chronic hepatitis C in children |
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Authors: | T Fujisawa H Komatsu A Inui Y Miyagawa M Onoue I Sekine S Yokota R Hanada K Yamamoto M Inui |
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Institution: | (1) Department of Paediatrics, National Defense Medical College, 3-2, Namiki, Tokorozawa-City, Saitama 359, Japan, Tel.: 429-95-1511, Fax: 429-96-5204, JP;(2) Department of Paediatrics, Yokohama City University School of Medicine, Japan, JP;(3) Department of Haematology and Oncology, Saitama Children's Medical Centre, Japan, JP;(4) Department of Pathology, Koutoh Hospital, Japan, JP |
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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.
Received: 9 April 1996 and in revised form: 8 April 1997 / Accepted: 15 April 1997 |
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Keywords: | Hepatitis C virus Chronic hepatitis C Natural history Spontaneous remission Children |
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