Seroprevalence of hepatitis C virus infection in children: A systematic review and meta-analysis

Transient elastography and diffusion-weighted magnetic resonance imaging for assessment of liver fibrosis in children with chronic hepatitis C

BACKGROUND

Chronic hepatitis C (CHC) is a health burden with consequent morbidity and mortality. Liver biopsy is the gold standard for evaluating fibrosis and assessing disease severity and prognostic purposes post-treatment. Noninvasive alternatives for liver biopsy such as transient elastography (TE) and diffusion-weighted magnetic resonance imaging (DW-MRI) are critical needs.

AIM

To evaluate TE and DW-MRI as noninvasive tools for predicting liver fibrosis in children with CHC.

METHODS

This prospective cross-sectional study initially recruited 100 children with CHC virus infection. Sixty-four children completed the full set of investigations including liver stiffness measurement (LSM) using TE and measurement of apparent diffusion coefficient (ADC) of the liver and spleen using DW-MRI. Liver biopsies were evaluated for fibrosis using Ishak scoring system. LSM and liver and spleen ADC were compared in different fibrosis stages and correlation analysis was performed with histopathological findings and other laboratory parameters.

RESULTS

Most patients had moderate fibrosis (73.5%) while 26.5% had mild fibrosis. None had severe fibrosis or cirrhosis. The majority (68.8%) had mild activity, while only 7.8% had moderate activity. Ishak scores had a significant direct correlation with LSM (P = 0.008) and were negatively correlated with both liver and spleen ADC but with no statistical significance (P = 0.086 and P = 0.145, respectively). Similarly, histopathological activity correlated significantly with LSM (P = 0.002) but not with liver or spleen ADC (P = 0.84 and 0.98 respectively). LSM and liver ADC were able to significantly discriminate F3 from lower fibrosis stages (area under the curve = 0.700 and 0.747, respectively) with a better performance of liver ADC.

CONCLUSION

TE and liver ADC were helpful in predicting significant fibrosis in children with chronic hepatitis C virus infection with a better performance of liver ADC.

Gender differences in prevalence of hepatitis C virus infection in Egypt: a systematic review and meta-analysis

Egypt is the country with the highest known hepatitis C virus (HCV) prevalence worldwide. The origin of gender differences in HCV prevalence is not usually well understood. This systematic review and meta-analysis aimed to review and evaluate the gender differences in HCV infection rates amongst Egyptians. Such data would be important to support prevention and control programs aiming to minimize HCV-related morbidity and mortality. PubMed, Scopus, and Web of Science (WOS) were searched for relevant articles published from 1st January 2011 to 13th December 2021, using the search terms (HCV OR "hepatitis C" OR hepacivirus) AND (prevalence OR seroprevalence OR epidemiology OR incidence OR magnitude). At first, retrieved articles were screened, and then relevant data were extracted and analyzed. Descriptive statistics were used for data analysis. Out of 616 studies from databases, only 30 were included after the full-text screening, with 193,621 included participants: 97,597 male and 96,024 female. The overall seroprevalence of HCV antibodies in all included studies was 0.02 (CI - 0.23 to 0.28), with no significant difference between males and females. However, HCV RNA positivity was significantly more prevalent in males than females in adults and the general population (after excluding high-risk groups). In children, no statistically significant differences between males and females were found in the seroprevalence of HCV antibodies nor in the prevalence of PCR positivity. HCV RNA positivity is significantly higher in males than females in adults, while there are no gender differences in children.