European Journal of Pediatrics

, Volume 171, Issue 2, pp 253–258

Spontaneous clearance of hepatitis C virus in vertically infected children

  • Susan Farmand
  • Stefan Wirth
  • Helga Löffler
  • Tanja Woltering
  • Sybille Kenzel
  • Elke Lainka
  • Philipp Henneke
Original Paper

DOI: 10.1007/s00431-011-1517-3

Cite this article as:
Farmand, S., Wirth, S., Löffler, H. et al. Eur J Pediatr (2012) 171: 253. doi:10.1007/s00431-011-1517-3

Abstract

Spontaneous viral clearance of hepatitis C virus (HCV) has been reported to occur in children with vertical HCV infection. However, factors which are associated with or predispose for clearance are largely unknown. In this case series we retrospectively analyzed laboratory parameters associated with spontaneous clearance of HCV in vertically infected children. The charts of six patients with documented spontaneous viral clearance by the age of 5 years were reviewed regarding clinical course, liver function tests (LFTs) and trend of HCV gene copy numbers. Spontaneous viral elimination was observed between the 25th and 52nd months of age. All patients had elevated LFTs, which peaked before 20 months of life. Peak LFT elevation was followed by normalization of LFTs and decline in viral load. These findings suggest that, in vertically HCV-infected children, a potent inflammatory response in the liver precedes viral clearance. Therefore, temporarily elevated LFTs, followed by a decline of viral load may be indicative of a near viral clearance in early childhood. Conclusion: Further investigations regarding the development of optimal treatment algorithms should take into account factors, which are associated with possible spontaneous viral resolution, such as viral genotype, favourable host factors as well as direct and indirect parameters of antiviral immunity, and the individual course of viral replication.

Keywords

Chronic hepatitis CChildrenVertical transmissionSpontaneous viral clearanceFavourable host factors

Abbreviations

ALT

alanine transaminase

AST

aspartate transaminase

ChLIA

chemiluminescent immunoassay

CMIA

chemiluminescent microparticle immunoassay

ECLIA

electrochemiluminescent immunoassay

HCV

hepatitis C virus

LFTs

liver function tests

PCR

polymerase chain reaction

RNA

ribonucleic acid

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Susan Farmand
    • 1
    • 2
  • Stefan Wirth
    • 3
  • Helga Löffler
    • 1
  • Tanja Woltering
    • 1
  • Sybille Kenzel
    • 1
    • 2
  • Elke Lainka
    • 4
  • Philipp Henneke
    • 1
    • 2
    • 5
  1. 1.Centre for Paediatrics and Adolescent MedicineUniversity of FreiburgFreiburgGermany
  2. 2.Centre of Chronic ImmunodeficiencyUniversity of FreiburgFreiburgGermany
  3. 3.Children’s Hospital Helios Klinikum WuppertalWitten-Herdecke UniversityWittenGermany
  4. 4.Children’s HospitalUniversity Duisburg-EssenEssenGermany
  5. 5.CCI FreiburgFreiburgGermany