Department of Pediatrics, University of Alberta, Edmonton, Canada.
Liver Int. 2012 Feb;32(2):258-70. doi: 10.1111/j.1478-3231.2011.02633.x. Epub 2011 Sep 11.
The outcome of patients with hepatitis C virus (HCV) infection acquired during childhood in the absence of antiviral therapy is not clear.
The purpose of this study was to review the outcome of untreated HCV acquired in childhood. Only population-based studies were included, as referred cases would be predicted to have more severe disease.
A systematic review of the literature was completed up to October 2010 to identify studies where a population was screened for HCV infection that was presumably acquired during childhood. Demographical and clinical data were collected on infected patients who had not been treated with an antiviral. Primary outcome was development of a severe adverse outcome (cirrhosis, hepatoma, need for a liver transplant or liver-related death).
There were 25 studies reporting a total of 733 infected patients. Liver biopsy results were provided for 180 patients (25%), revealing cirrhosis in eight (1.0% of the total and 4.0% of those who had a biopsy). None of the other patients developed a severe adverse outcome. As a result of the small number of patients with a severe adverse outcome, risk factors for HCV progression could not be identified.
Although HCV can lead to liver transplantation and death during childhood, the vast majority of patients with disease acquired during childhood have slowly progressive disease. There is no clear indication for antiviral therapy in the majority of children with HCV infection.
未经抗病毒治疗的儿童时期获得丙型肝炎病毒（HCV）感染患者的结局尚不清楚。
本研究旨在回顾未治疗的儿童时期获得的 HCV 的结局。仅纳入基于人群的研究，因为所研究的病例可能具有更严重的疾病。
系统检索截至 2010 年 10 月的文献，以确定筛查可能在儿童时期获得 HCV 感染的人群的研究。收集未接受抗病毒治疗的感染患者的人口统计学和临床数据。主要结局为发生严重不良结局（肝硬化、肝癌、需要进行肝移植或与肝脏相关的死亡）。
有 25 项研究报告了总共 733 名感染患者。对 180 名患者（25%）进行了肝活检，结果显示 8 名（占总人数的 1.0%，活检患者的 4.0%）患有肝硬化。其他患者均未发生严重不良结局。由于严重不良结局的患者数量较少，因此无法确定 HCV 进展的危险因素。
尽管 HCV 在儿童时期可导致肝移植和死亡，但大多数儿童时期获得的疾病患者的疾病进展缓慢。大多数 HCV 感染儿童没有明确的抗病毒治疗指征。
