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Only population\u2010based studies were included, as referred cases would be predicted to have more severe disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the literature was completed up to October 2010 to identify studies where a population was screened for <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infection that was presumably acquired during childhood. Demographical and clinical data were collected on infected patients who had not been treated with an antiviral. Primary outcome was development of a severe adverse outcome (cirrhosis, hepatoma, need for a liver transplant or liver\u2010related death).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 25 studies reporting a total of 733 infected patients. Liver biopsy results were provided for 180 patients (25%), revealing cirrhosis in eight (1.0% of the total and 4.0% of those who had a biopsy). None of the other patients developed a severe adverse outcome. As a result of the small number of patients with a severe adverse outcome, risk factors for <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> progression could not be identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> can lead to liver transplantation and death during childhood, the vast majority of patients with disease acquired during childhood have slowly progressive disease. There is no clear indication for antiviral therapy in the majority of children with <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1478-3231.2011.02633.x","type":"journal-article","created":{"date-parts":[[2011,9,12]],"date-time":"2011-09-12T01:40:29Z","timestamp":1315791629000},"page":"258-270","source":"Crossref","is-referenced-by-count":21,"title":["The natural history of hepatitis C virus infection acquired during childhood"],"prefix":"10.1111","volume":"32","author":[{"given":"Joan L.","family":"Robinson","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Alberta Edmonton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Doucette","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Alberta Edmonton 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