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World J Gastroenterol. May 28, 2007; 13(20): 2846-2851
Published online May 28, 2007. doi: 10.3748/wjg.v13.i20.2846
Assessment of hepatic fibrosis in pediatric cases with hepatitis C virus in Egypt
Manal A El-Hawary, Mona S El-Raziky, Gamal Esmat, Hanan Soliman, Amr Abouzied, Maissa El-Raziky, Wafaa El-Akel, Rokaya El-Sayed, Fatma Shebl, Abdel Aziz Shaheen, Hanaa El-Karaksy
Manal A El-Hawary, Department of Pediatrics, Fayoum University, Egypt
Mona S El-Raziky, Rokaya El-Sayed, Hanaa El-Karaksy, Department of Pediatrics, Cairo University, Egypt
Gamal Esmat, Maissa El-Raziky, Wafaa El-Akel, Department of Tropical Medicine, Cairo University, Egypt
Hanan Soliman, Department of Pathology, Cairo University, Egypt
Amr Abouzied, Abdel Aziz Shaheen, Department of Tropical Medicine, Hepatitis C Project, Egypt
Fatma Shebl, Department of Public Health, National Liver Institute, Egypt
Author contributions: All authors contributed equally to the work.
Correspondence to: Manal A EL-Hawary, MD, Associate Professor of Pediatrics, Faculty of Medicine-Fayoum University, Postal address: 3 Mossadak street, Dokki, Cairo, Egypt. manalelhawary@yahoo.com
Telephone: +20-2-7600350 Fax: +20-10-1584525
Received: February 1, 2007
Revised: February 25, 2007
Accepted: March 1, 2007
Published online: May 28, 2007
Abstract

AIM: To assess hepatic fibrosis and factors associated with its progression in children with HCV infection.

METHODS: At the Hepatology Unit, Cairo University Children’s Hospital, a single liver biopsy was performed to 43 children with HCV infection after an informed consent between 1998-2004. Their mean age at liver biopsy was 8.67 ± 4.3 years.

RESULTS: Among the 43 patients’ biopsies, 12 (27.9%) were having no fibrosis, 20 (46.5%) mild fibrosis and 11 (25.6%) moderate to severe fibrosis. The median time for development of fibrosis was estimated to be 5.5 years. Developing fibrosis was significantly associated with shorter duration from first detected ALT elevation to biopsy (12 mo vs 1.2 mo, P = 0.015) and having higher levels of direct serum bilirubin (0.3 mg/dL vs 0.5 mg/dL, P = 0.048). No association was found between fibrosis stage and the presence of co-morbid conditions (P = 0.33).

CONCLUSION: Hepatic fibrosis was present in 72.1% of children with HCV infection. The development of fibrosis was associated with higher levels of direct serum bilirubin. There was no significant association between fibrosis and age, duration of infection, risk factors, co-morbid conditions and most biochemical parameters.

Keywords: Children; Egypt; Fibrosis; Hepatitis C virus; Liver