Chronic hepatitis C infection has been associated with increased collagen deposition leading to hepatic fibrosis and cirrhosis. The mechanism of hepatocarcinogenesis is unclear. The role of oxidative stress secondary to chronic inflammation has been implicated which may produce oxidative DNA damage. It is critically important to understand the evolution of the disease in young subjects, because these subjects have the longest potential benefit from antiviral therapy and strategies to prevent the development of liver fibrosis, cirrhosis and cancer. In addition, children are biologically naive, so an in depth study of HCV in children (who are free of alcoholism and other confounding variables) could yield a clearer understanding of the hepatogenesis of the virus.