HEPATITIS-C SEROTYPES IN CHRONIC HEPATITIS-C OF CHILDREN

An enzyme linked immunosorbent assay has been recently developed which detects and distinguishes between infections with the three major hepatitis C virus (HCV) genotypes prevalent in Europe. Using this assay we have investigated the sera of 30 Italian and 37 Spanish children with chronic hepatitis C. Infection with HCV type 1 was found in 43% of Italian and 46% of Spanish children. Of the Italian children 7% were infected with HCV of type 2 and 7% had a mixed type 1/type 2 serotype. Infection with HCV type 3 was found in 7% of Italian and 8% of Spanish children while 36% of Italian and 46% of Spanish children had non-reactive sera. Serotype 3 was significantly more frequent in children with anti-HCV positive mothers (often drug abusers) than in those with percutaneous exposure (25% vs. 2%, p < 0.05). Mean alanine aminotransferase values were significantly higher in children with HCV type 1 than in those with non-reactive sera (P < 0.05). These results indicate a similar distribution of HCV serotypes in Italian and Spanish children. Serotype 1 is prevalent and associated with a more severe liver damage. The relevant proportion of non-reactive sera could be related to the existence of genetic variants different from those explored by the test and with low pathogenicity, or to a poor antibody response to viral antigens of the NS4 region in a consistent subgroup of children.