The study was

conducted with Institutional Review Board approval from each participating center. General demographic data included gender, ethnicity, selleck chemical age at infection, duration of infection to biopsy, source of infection (vertical, transfusion, and unknown), and body mass index (BMI) Z-scores. The putative date of infection was defined as the date of birth in those who acquired HCV vertically, or the date of transfusion or any surgery, presumed exposure to contaminated needles during hospitalization; if none of the above was known, these data were excluded from the calculation of duration of infection to biopsy. Laboratory values within 3 months of the initial and follow-up biopsies including complete blood count, serum alanine aminotransferase (ALT), total and direct bilirubin, prothrombin time, albumin, and HCV RNA quantification by polymerase chain reaction (PCR) were retrieved from retrospective chart review. Viral genotype was included when available. All PLX3397 cell line biopsies were scored for inflammation, fibrosis, and steatosis by a single pathologist to guarantee uniformity of interpretation. They were coded in a uniform manner and the pathologist was blinded to clinical data, the sequence of the biopsies, and the histologic scoring originally performed.[22] Liver biopsies

were evaluated for necroinflammation (grade) with the modified Histology Activity Index (HAI) and fibrosis (stage) by Ishak classification.[22] Demographic data and laboratory values were correlated with histologic grading (grade of inflammation 0-18) and staging (stage of fibrosis 0-6) from the initial and repeat biopsies to assess if there were significant

histologic changes between the biopsies and to identify any factors that predicted progression of liver disease in these children and adolescents. If there were more than two biopsies performed on the same patient, the first and last biopsies were used for statistical analysis. For comparative purposes, necroinflammatory scores were collapsed to none/minimal (HAI: 0-3), mild (4-6), moderate (7-9), and marked ≥10. Fibrosis scores were collapsed to none (stage 0), portal/periportal (stages 1-2), bridging fibrosis and cirrhosis (stages 3-6). Data were organized to enable determination of changes 上海皓元 from the first to the last liver biopsy. Percentages, means, and SDs were calculated in the usual way. For categorical/binary variables, contingency table analysis was used to assess the relationship between two variables with reference to the likelihood ratio chi-square for the P value. The likelihood ratio chi-square was used because it is robust with small sample sizes and small cell sizes. For continuous variables, a standard t test was used for comparison of means between two groups (adjusting for heterogeneity of variance as appropriate) and a standard analysis of variance (ANOVA) for comparison of means among three or more groups. No adjustment was made for multiple comparisons.