Lipid metabolism in children with chronic hepatitis C, A preliminary report.

Background/aims: The importance of lipid metabolism in the pathogenesis of chronic hepatitis C has been recognized in recent years. Bearing in mind remote sequelae of chronic hepatitis C in children, it seems reasonable to seek to determine potential risk factors for the development of cirrhosis and carcinogenesis. The aim of the study was to assess lipid metabolism in children with chronic HCV-related hepatitis.

Methodology: The study comprised 16 children with chronic hepatitis C and 16 healthy controls. In all the children anthropometric data and after, overnight fasting, serum levels of total bilirubin, AST, ALT, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were investigated. In the study group biopsy specimens were assessed.

Results: Macrovesicular steatosis in numerous hepatocytes was found in 3 children. Total cholesterol level in children with chronic hepatitis was significantly lower than in control group (p < or = 0.05). Mean values of body mass, height, body mass index (BMI), levels of bilirubin, HDL-cholesterol, LDL-cholesterol, triglycerides and HDL/C index did not differ significantly between the two groups. No correlation between lipid parameters and histological markers, hepatic enzymes, patient age, weight, height or BMI was found.

Conclusions: Neither obesity nor hyperlipidemia, which are recognized risk factors for steatosis were found in children with HCV-related hepatitis. Lower cholesterol levels in children with chronic HCV infection compared to the controls and only scarce signs of steatosis which were noted could suggest the risk, existing already in such young patients, of developing fatty liver disease with its consequences including cirrhosis and neoplastic disease.