Search

Chronic hepatitis C is still an important health problem in children. Adequate management of those patients should be focused on two directions: disappearance or reduction of the viral load (conventional antiviral therapy) and treatment of autoimmune manifestations (corticoids, plasmapheresis, cytotoxic agents).To associate extrahepatic manifestations with other disorders and to evaluate the evolution under specific (antiviral) and non-specific therapy.43 children diagnosed with chronic hepatitis C and followed in the 2nd Pediatric Clinic Iaşi between January 2005 and June 2010.most children were diagnosed accidentally or for etiological investigations for elevated liver enzymes. Extrahepatic manifestations were found in 41.86% of patients, most of them with articular, skin and hematologic disorders, but also depression (2 cases) in those receiving interferon.In children, extrahepatic manifestations in chronic hepatitis C infection are more rare than in adults, especially with articular involvement. In certain cases, interferon therapy can trigger those manifestations with an immune mechanism. It is essential to evaluate the autoimmunity markers before proceeding with antiviral therapy.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the frequent causes of acute and chronic hepatitis worldwide and the leading causes for hepatic cirrhosis and liver cancer. There is a distinct geographical variation in VHB and VHC incidence in adult and child.To assess the evolution trend of VHB and VHC incidence in child, in Romania and Iasi County, during the last two decades.Data were obtained using information from the Reporting National System for acute viral hepatitis A, B, and C, from various geographical areas of Romania. Some systematical errors of information were identified, without significant influence of results and conclusions.Results highlighted an incidence peak of VHB in Romania, in 1989, and in Iaşi county, in 1991 (43.1, respectively 41.2 per thousand inhabitants). The VHB incidence trend decreased after the implementation of vaccination programme, especially in children4 years old.The study remarked the necessity of viral hepatitis surveillance programme continuity in Romania and the importance of prevention measures including, for VHB, an optimal vaccination.

The evolution of chronic viral and non-viral hepatitis in children, and the response to therapy influence the quality of life and the outcome of these patients and tehir family.This study analyzes the quality of life in children with chronic liver disease, using the records of 45 patients hospitalised in the Hepatology Department of "Sf. Maria" Hospital of Children in Iaşi. Data were customised using Kindle questionnaire, measuring the scores for quality of life in children and adolescents with chronic disease. Patients with chronic viral and autoimmune hepatitis hospitalised in the clinic were interrogated during three months (May-July 2008). All ethical aspects of clinical research were aproved and no child was harmed during the study. The questionnaire for children with chronic viral hepatitis, mostly with B virus, had a good aplicability, being simple and easy to respond.The results showed a positive perception of the disease, probably because of the young age (under 17) and the fact that the liver disfunction was at low rates. The study of quality of life in children with chronic disease can be an efficient method for treatment efficiency evaluation.