Is HCV infection associated with liver steatosis also in children?

Prevalence and significance of steatosis in children with chronic hepatitis C are not well defined. We analysed the prevalence of steatosis in children with chronic hepatitis C and its relationship with clinical, laboratory features and response to interferon. Sixty-four consecutive children with CHC undergoing liver biopsy were retrospectively evaluated. Twenty-five percent of children showed mild to moderate steatosis. Only one child was infected by genotype 3. Body mass index did not significantly differ between children with and without steatosis. Although no significant difference in necroinflammatory and fibrosis scores between children with and without steatosis was found, 3 (18.7%) of 16 patients with steatosis and only one (2.1%) of 48 patients without steatosis had a fibrosis score >2 (P<0.05). Forty-seven children (13 with steatosis) received interferon after liver biopsy. A sustained response was observed in 3 (23%) children with steatosis and in 18 (53%) without steatosis. Histological evidence of steatosis is detectable in a quarter of children with CHC. Differently from adults, genotypes other than 3 may be associated with steatosis independently from classical metabolic risk factors. Children with steatosis seem to have more severe fibrosis and lower rates of sustained response to interferon therapy compared to children without steatosis.