Transplantation 1993 Apr;55(4):795-8

Hepatitis C virus infection in pediatric liver transplantation

Dussaix E, de Paillette L, Laurent-Puig P, Martres P, Lykavieris P, Bernard O,
Alvarez F
Laboratoire de Virologie, Hopital de Bicetre, Le Kremlin-Bicetre, France

Abstract
To determine the prevalence of antibodies to hepatitis C virus (HCV) and the
short-term evolution of HCV infection in children undergoing orthotopic liver
transplantation, we retrospectively studied the sera and medical records of 149
children surviving from 9 months to 5 years after OLT. Fourteen children (9.4%)
were found to be positive for anti-HCV with second-generation ELISA and RIBA
tests. They were individualized in 2 distinctive groups. In 5 children, anti-HCV
was present before OLT, and in 1 patient only HCV RNA was detected at that time.
All 6 patients were positive for anti-HCV after OLT. In the other 8 children,
anti-HCV and HCV RNA were only detected after OLT and likely reflect infection
during or shortly after OLT. The antibody reactivities against the 3 antigens
included in the second-generation RIBA test varied in a given patient throughout
follow-up and between these 2 groups of children. In all patients, serum
transaminase (ALT) activities returned to normal levels when prednisone therapy
was lowered and given every other day. These results indicate that the search
for HCV infection in these children is necessary in the differential diagnosis
of other liver complications in order to avoid excessive immunosuppressive
treatment