Clinical and laboratory profiles of hepatitis C in hemophiliac children

  • Hanifah Oswari
  • Ferry Damardjati S.P.
  • Djajadiman Gatot
  • Zakiudin Munasir
  • Julfina Bisanto
DOI: https://doi.org/10.14238/pi47.5.2007.229-33
Keywords: HCV, hemophiliacs children, ALT, HCV RNA test

Abstract

Background Hepatitis C virus (HCV) infection is common in hemophiliac receiving multiple coagulation factor transfusions before the introduction of donor screening and viral inactivation techniques. Information on the clinical profiles of HCV infection in children is still limited.

Objective To describe clinical and laboratory profiles of HCV infection in hemophiliac children. 

Methods Patients registered at the Hemophilia Society of Department of Child Health, Cipto Mangunkusumo Hospital, who had positive anti-HCV were enrolled. None of them received antiviral treatment. All subjects infected by HCV before the age of 18 years and at least had positive anti-HCV test result for 6 months underwent clinical examination, alanine aminotransferase (ALT), platelets, and HCV RNA tests.


Results Thirty nine subjects were available for review, with the median age of 15 years, and the mean age of the first time getting transfusion was 15 months. Twenty two (56%) of 39 subjects showed clinical manifestations. Liver and spleen enlargement were not found in any of the subjects. Ten (26%) subjects showed elevated ALT. Platelet count was within normal limit in all subjects. Twenty four (61%) patients had chronic hepatitis, whereas the remaining 15 (39%) subjects spontaneously cleared from HCV.

Conclusions Pediatric HCV infection showed mild clinical manifestations. Sixty one percent subjects developed chronic hepatitis. The abnormality of laboratory finding may be associated with the future chronic liver disease.

Author Biographies

Hanifah Oswari
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Ferry Damardjati S.P.
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Djajadiman Gatot
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Zakiudin Munasir
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Julfina Bisanto
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

References

1. Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M. Isolation of a cDNA clone derived from blood-borne non-A, non-B viral hepatitis genome. Science 1989;244:359-62.
2. Kuo G, Choo QL, Alter HJ, Gitnick GL, Redeker AG, Purcell RH, et al. An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science 1989;244:362-4.
3. Makris M, Preston FE, Trige DR, Underwood JC, Choo QL, Kuo G, et al. Hepatitis C antibody and chronic liver disease in haemophilia. Lancet 1990;335:1117-9.
4. Ghannaei FM, Fallah MS, Shafaghi A, Mashhoor MY, Ramezani N, Farzaneh F, et al. Prevalence of hepatitis B and C seromarkers and abnormal liver function test among hemophiliacs in Guilan (northern province of Iran). Med Sci Monit 2002;8:797-800.
5. Brettler DB, Alter HJ, Dienstag JL, Forsberg AD, Levine PH. Prevalence of hepatitis C antibody in a cohort of hemophilia patients. Blood 1990;76:254-6.
6. Troisi CL, Hollinger B, Hoots WK, Contant C, Gill J, Ragni M, et al. A multicenter study of viral hepatitis in United States hemophilic population. Blood 1993; 81:412-8.
7. Blanchette VS, Vorstman E, Shore A, Wang E, Petric M, Jett BW, et al. Hepatitis C infection in children with hemophilia A and B. Blood 1991;78:285-9.
8. Barbosa AP, Martins RMB, Teles SA, Silva SA, Oliveira JM, Yoshida CFT. Prevalence of hepatitis C virus infection among hemophiliacs in central Brazil. Mem Inst Oswaldo Cruz 2002;97:643-4.
9. Partiwi IGAN. Hepatitis C pada penderita hemofila [Thesis]. Jakarta: Departemen Ilmu Kesehatan Anak FKUI; 2000.
10. Esteban JI, Gonzales A, Hernandez JM, Viladomiu L, Sanchez C, Talavera JL, et al. Evaluation of antibodies to hepatitis C virus in a study of transfusion-associated hepatitis. N Engl J Med 1990;323:1107-12.
11. Tobler LH, Busch MP. History of posttransfusion hepatitis. Clin Chem 1997; 43:1487-93.
12. Hoshiyama A, Kimura A, Fujisawa T, Kage M, Kato H. Clinical and histologic features of chronic hepatitis C virus infection after blood transfusion in Japanese children. Pediatrics 2000;105:62-5.
13. Jonas MM. Children with hepatitis C. Hepatology 2002;36:S173-8.
14. Hoofnagle JH. Course and outcome of hepatitis C. Hepatology 2002;36:S21-9.
15. Posthouwer D, Wolters VM, Fischer K, Houwen RH, van den Berg HM, Mauser-Bunschoten EP. Hepatitis C infection in children with haemophilia: a pilot study. Haemophilia 2004;10:722-6.
16. Franchini M, Rossetti G, Tagliferri A, Capra F, de Maria E, Pattacini C, et al. The natural history of chronic hepatitis C in a cohort of HIV-negative Italian patients with hereditary bleeding disorders. Blood 2001;98:1836-41.
17. Yee TT, Griffloen A, Sabin CA, Dusheiko G, Lee CA. The natural history of HCV in a cohort of hemophilic patients infected between 1961 and 1985. Gut 2000;47:845-51.
18. Hoshiyama A, Kimura A, Fujisawa T, Kage M, Kato H. Clinical and histologic features of chronic hepatitis C virus infection after blood transfusion in Japanese children. Pediatrics 2000;105:62-5.
19. Jonas MM. Children with hepatitis C. Hepatology 2002;36:S173-8.
20. Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med 2001;345:41-52.
21. Barrera JM, Bruguera M, Ercilla GM, Gil C, Celis R, Gil MP, et al. Persistent hepatitis C viremia after self-limiting posttransfusion hepatitis C. Hepatology 1995;21:639-44.
22. Casiraghi MA, De Paschale, Romano L. Long-term outcome (35 years) of hepatitis C after aquisition of infection through mini transfusions of blood given at birth. Hepatology 2004;39:90-6.
23. Vogt M, Lang T, Frosner G, Klingler C, Sendl AF, Zeller A. Prevalence and clinical outcome of hepatitis C infection in children who underwent cardiac surgery before the implementation of blood-donor screening. N Engl J Med 1999;341:866-70.
24. Tovo PA, Pembrey RJ, Newll ML. Persistence rate and progression of vertically aquired hepatitis C infection. J Infect Dis 2000;181:419-24.
25. Minola E, Prati D, Suter F, Maggiolo F, Caprioli F, Sonzogni A, et al. Age at infection affects the long-term outcome of transfusion-associated chronic hepatitis C. Blood 2002; 99:4588-91.
26. Tong MJ, El-Farra N, Reikes AR, Co RL. Clinical outcomes after transfusion associated hepatitis C. N Engl J Med 1995;332:1463-6.
27. Gerlach JT, Zachoval R, Gruener NH, Jung MC, Ulsenheimer A, Schraut W, Waechtler M, et al. Acute hepatitis C: natural course and response to antiviral treatment. Hepatology 2001;34:341.
28. Park GJ, Lin BPC, Ngu MC, Jones DB, Katelaris PH. Aspartate aminotransferase: alanine aminotransferase ratio in chronic hepatitis C infection: is it a useful predictor of cirrhosis? J Gastro Hepatol 2000;15:386-90.
29. Erlita. UTDD DKI Jakarta PMI. Personal communication 21-2-2003.
Published
2007-10-31
How to Cite
1.
Oswari H, S.P. F, Gatot D, Munasir Z, Bisanto J. Clinical and laboratory profiles of hepatitis C in hemophiliac children. PI [Internet]. 31Oct.2007 [cited 20Apr.2024];47(5):229-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/420
Issue
Vol 47 No 5 (2007): September 2007
Section
Articles

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Received 2016-09-01
Accepted 2016-09-01
Published 2007-10-31