Features of the Course of Viral Hepatitis C in Children

Viral hepatitis C is a serious global problem. According to the WHO, about 150-200 million people suffer from hepatitis C, and 350 thousand people die each year from complications. Hepatitis C morbidity and mortality is progressively increasing and, according to experts, will double by 2020. Although the prevalence of chronic viral hepatitis C is lower in children than adults, about 5 million children worldwide have active viral hepatitis C infection. Results and discussion. Viral hepatitis C is an infectious disease caused by the hepatitis C virus, with a hemocontact mechanism of transmission of the pathogen and a primary lesion of the liver and other internal organs. 11 viral hepatitis C genotypes are known. Viral hepatitis C infection in children differs from adults in several aspects. But the data on this issue is ambiguous. As compared to adults, knowledge of hepatitis C virus infection in children is limited. This is because far fewer children are infected with hepatitis C virus, and children are less likely to have symptoms from their hepatitis C virus infection. More than three quarters of the children are symptomless. Minimal nonspecific and brief symptoms are initially found in approximately 15% of children. These symptoms can be in the form of hyperpyrexia, lethargy, anorexia, nausea, vomiting, and abdominal colic. They can present with deep-colored urine, light-colored feces, arthralgia and yellowish discoloration of skin and sclera. In developed countries the children are infected mainly through vertical transmission during deliveries, while in developing countries it is still due to horizontal transmission from adults. Vertical transmission in infants and children can affect 4% to 10% of infants born to viral hepatitis C infected mothers. The risk of vertical transmission escalates when mothers have high viral load and when there is maternal co-infection with human immunodeficiency virus. When the density of maternal viral hepatitis C was 1 million particles per milliliter, the rate of vertical transmission reached 36%. The progression of viral hepatitis C infection to such serious outcomes as cirrhosis and hepatocellular cancer is well studied in adults, but little is known about the long-term outcome of infection in children. It is believed that in children there is a high frequency of spontaneous regression of chronic viral hepatitis C, a slower rate of disease progression than in adults, a predominantly mild asymptomatic course with a slight increase in transaminase level. Indeed, according to a number of investigations, spontaneous remission in children occurs in 25-40% of cases. But we have found and other studies. According to these studies, 60% of the viral hepatitis C RNA-positive children, whom a diagnostic liver biopsy was made, showed chronic hepatitis in 73%, cirrhosis in only one, while seven children (27%) had normal liver biopsies. So, viral hepatitis C infection is frequently not a benign disease during childhood. Conclusions. Thus, studying the literature data, we can conclude that there are number of contradictory data that require further study of viral hepatitis C infection in children.