Clinical and laboratory characteristics of chronic hepatitis C in children with different levels of aminotransferases

Aminotransferases reflect the volume and degree of liver damage with the development of inflammation in chronic hepatitis C, correlate with fibrosis, therefore their determination in such patients is of both scientific and practical importance. The aim of the study is determination of the clinical course, dynamics of laboratory and instrumental parameters in children with HCV who received direct antiviral therapy, depending on the initial level of aminotransferases in blood serum. Materials and methods . 36 patients aged 3—16 years were under observation, randomized depending on the level of aminotransferases in the blood serum. All children underwent a regulated clinical, laboratory and instrumental examination before starting treatment with the direct antiviral drug glecaprevir/pibrentasvir, 12 weeks and 6 months after the start of the course of therapy. Results . Patients with high levels of aminotransferases were more likely to become infected with HCV perinatal compared with children with normal levels of these enzymes in the blood serum. The age and clinical symptoms in both groups did not differ. Aminotransferases were initially elevated in 27.8% of children with chronic hepatitis C, while their maximum level did not exceed 4 norms. The appointment of a course of direct antiviral therapy with glecaprevir / pibrentasvir contributes to a fairly rapid and stable normalization of aminotransferase levels in all patients in both groups, regardless of their initial amount. HCV genotype 1b prevailed in both children with high levels of aminotransferases and those with normal levels, and the viral load was low in the group with normal levels of aminotransferases. Faster normalization of liver size according to ultrasound data in patients with normal aminotransferase levels under the influence of direct antiviral therapy indicates a direct correlation between the level of aminotransferases and the degree of liver damage in chronic hepatitis C. However, more pronounced fibrosis in 1 child (up to grade F3 on the METAVIR scale) in this group indicates the need for close attention even to those children whose aminotransferase levels remain normal, which does not exclude the course of their fibrotic process in the liver. Conclusion . Thus, it can be assumed that the baseline level of aminotransferases in children with HCV is important for assessing the degree of liver damage and allows predicting the effectiveness of direct antiviral therapy.